An assistive personnel (AP) comes to work with a new set of artificial nails. The nurse takes the AP to a private location to discuss the issue. Which of the following statements by the nurse is appropriate?
"I want you to review the facility's policy on personal attire before you begin the shift."
"There is a higher risk of infection for our clients associated with artificial nails."
"Why would you wear artificial nails to work when you know it's against the rules?"
"You should know that artificial nails have a very unprofessional appearance."
The Correct Answer is B
Rationale:
A. "I want you to review the facility's policy on personal attire before you begin the shift." does not address the specific concern regarding infection risk related to artificial nails.
B. "There is a higher risk of infection for our clients associated with artificial nails." provides a clear and factual explanation of why artificial nails are not appropriate, focusing on client safety rather than personal appearance or policy.
C. "Why would you wear artificial nails to work when you know it's against the rules?" is confrontational and does not address the issue in a constructive manner.
D. "You should know that artificial nails have a very unprofessional appearance." focuses on appearance rather than the potential risk to clients' health.
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Correct Answer is D
Explanation
Rationale:
A. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6 needs pain management, but this is less urgent compared to potential signs of hypotension.
B. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous indicates normal progression of wound healing; thus, it is less critical.
C. A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL needs blood glucose management, but this is less urgent than assessing for potential hypovolemia or shock.
D. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg is experiencing a significant drop in blood pressure, which could indicate hypovolemia or shock. This requires immediate assessment and intervention to prevent complications.
Correct Answer is A
Explanation
Rationale:
A. Check to see if the elbow restraint is in place for an infant who is postoperative from a surgical correction of a cleft palate is a priority to ensure the safety and proper positioning of a vulnerable postoperative patient.
B. Wash the hair of an adolescent who reports extreme fatigue and is scheduled for radiation therapy for the treatment of Hodgkin lymphoma can be done later, as it is not as critical as ensuring the safety of a postoperative infant.
C. Collect a stool sample for ova and parasites from a school-age child is important but not as urgent as checking restraints for a postoperative infant.
D. Engage a toddler in play is important for developmental support but is not as urgent as tasks directly related to patient safety and postoperative care.