Nurses working on a surgical unit are concerned about a healthcare provider's treatment of clients during invasive procedures, such as dressing changes and insertion of IV lines. Clients are often crying during the procedures, and the healthcare provider is usually unconcerned or annoyed by the client's response. To resolve this problem, which actions should the nurses take? (Arrange from the first action on top to last on the bottom.)

Submit a written report to the Director of Nursing.

File a formal complaint with the state medical board.

Document concerns and report them to the charge nurse.

Talk to the healthcare provider as a group in a non-confrontational manner.

Contact the hospital's Chief of Medical Services.

Answer and Explanation

The Correct Answer is C,D,A,E,B

A. Submit a written report to the Director of Nursing is appropriate if the behavior persists after addressing it directly with the provider and reporting to the charge nurse. This escalates the concern to senior nursing leadership for further intervention.

B. File a formal complaint with the state medical board is the last step. This external action is reserved for cases where all internal resolution attempts have failed or the provider’s behavior places clients at significant risk of harm.

C. Document concerns and report them to the charge nurse is the first and most appropriate step. This follows the chain of command, ensures the issue is formally recorded, and allows unit leadership to be aware of the problem. Documentation provides an objective record of events and client responses.

D. Talk to the healthcare provider as a group in a non-confrontational manner is the next step. Addressing the provider directly, professionally, and collaboratively may resolve the behavior without escalation. This encourages open communication and allows the provider to correct actions.

E. Contact the hospital's Chief of Medical Services is a higher-level administrative step to involve hospital leadership if prior attempts fail. This ensures the concern is addressed at the executive level and protects client safety.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Prostate infections, such as prostatitis, can cause inflammation and irritation of the prostate gland, which can lead to elevated PSA levels. This is an important factor to explain to the client because PSA elevation is not specific to cancer alone; other benign conditions can also increase PSA. Understanding this helps reduce unnecessary anxiety and informs appropriate follow-up testing.

B. Prostatectomy involves surgical removal of the prostate gland. After a complete prostatectomy, PSA levels typically decrease to undetectable levels rather than increase. Therefore, this procedure would not cause elevated PSA.

C. Tobacco use is associated with various cancers and cardiovascular disease but does not directly elevate PSA levels. While smoking has systemic effects, it is not a recognized cause of increased PSA.

D. Alcohol consumption affects liver function and overall health but is not linked to elevated PSA levels. There is no direct correlation between alcohol intake and PSA elevations in prostate screening.

A. Explain that no dietary restrictions are needed with warfarin. B. Provide a written list of additional foods high in potassium. C. Review teaching about the effects of foods rich in Vitamin K. D. Discuss necessary fluid restrictions as well as food restrictions.

Correct Answer is C

Explanation

A. Explaining that no dietary restrictions are needed with warfarin is incorrect. While potassium-rich foods do not affect warfarin, the client still requires education about the influence of Vitamin K on anticoagulation. Warfarin works by inhibiting Vitamin K–dependent clotting factors, and sudden changes in Vitamin K intake can reduce the drug’s effectiveness or increase the risk of bleeding. Simply stating that no restrictions are needed does not address this critical safety concern.

B. Providing a written list of foods high in potassium is inappropriate because potassium intake does not interfere with warfarin therapy. Giving this information could reinforce the client’s misunderstanding and distract from the key teaching about maintaining a consistent intake of Vitamin K to ensure safe anticoagulation.

C. Reviewing teaching about the effects of foods rich in Vitamin K is correct. Clients on warfarin must maintain consistent Vitamin K intake to prevent fluctuations in anticoagulation levels. The nurse should explain that foods such as leafy greens, broccoli, and certain vegetable oils can influence warfarin’s effectiveness. The client does not need to avoid these foods completely but should eat them consistently while monitoring for signs of bleeding or bruising and keeping regular INR checks. This response directly addresses the client’s misconception and ensures safe, effective management of warfarin at home.

D. Discussing fluid restrictions and other food restrictions is irrelevant for a client on warfarin. Fluid management is not typically related to anticoagulation therapy, and introducing unnecessary restrictions could confuse the client and divert attention from the primary teaching about Vitamin K.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 71-year-old client is concerned about an elevated prostate-specific antigen (PSA) level because he understands that an elevated PSA is a possible indication of prostate cancer. Which factor should the nurse explain can also cause an elevated PSA level?

Correct Answer is A

Explanation

Following a total knee arthroplasty, the client is discharged from the hospital with a prescription for warfarin. In reviewing discharge teaching, the client recounts to the nurse the need to avoid eating foods high in potassium, such as bananas and melon. How should the nurse respond?

Correct Answer is C

Explanation

A client is admitted with the diagnosis of Wernicke's syndrome. Which assessment finding should the nurse use when developing the client's plan of care?

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The nurse is evaluating a client's outcomes. Which statement indicates a client has achieved improved health?

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