Emergent Care Clinic

The Emergent Care Clinic RN Case Study The Emergent Care Clinic is a fast-paced, 20-bed, free-standing, acute care facility. The Emergent Care interdisciplinary team includes registered nurses (RN), licensed practical nurses (LPN), unlicensed assistive personnel (UAP), physicians, advanced practice registered nurses (APRN), and other collaborative care team members. The facility is located in an urban area and is open for business 24 hours a day, 7 days a week. Which client should the charge nurse assign to the PN? A 20-year-old female who complains of pain to the right lower leg with swelling after tripping on the sidewalk. Mr. Jackson, the 45-year-old male client reporting left arm pain and gastrointestinal upset, is assigned to an RN. It is most important for the RN to admit Mr. Jackson to which room in the Emergent Care Clinic? A room with a continuous cardiac telemetry monitor. A room with a continuous cardiac telemetry monitor. The UAP assists the RN in getting Mr. Jackson admitted. Which tasks should the RN delegate to the UAP? Enter the obtained vital signs in the medical record. Place a bedside commode in the room. Enter the obtained vital signs in the medical record. Place a bedside commode in the room. Which action should the RN delegate to the UAP next? Apply a continuous pulse oximeter monitor to the client. Apply a continuous pulse oximeter monitor to the client. Mr. Jackson also reports dull, aching pain from his left shoulder radiating to his left arm. He states the pain comes and goes, and he rates the pain as 5 on a pain scale of 0 to 10. The RN applies electrodes form the ECG machine to obtain a tracing of Mr. Jackson's heart function and then analyzes Mr. Jackson's ECG strip, which shows a normal sinus rhythm. Which prescription should the RN plan to implement first for Mr. Jackson? Oxygen at 4 liters per nasal cannula. Which inquiry is most important for the RN to make first? List of current prescription and over-the-counter medications. After the RN receives Mr. Jackson's laboratory results, which data is most important to report to the primary HCP? Serum potassium 2.9 mEq/L After the RN receives Mr. Jackson's laboratory results, which data is most important to report to the primary healthcare provider (HCP)? Serum potassium 3.0 mEq/L. Finger-stick glucose 180 mg/dL. The PCP prescribes a potassium supplement and sublingual nitro. Potassium chloride 40 mEq PO Stat is prescribed. The suppis is potassium chloride 20 mEq per tablet. The charge nurse notes that Mr. Jackson's primary RN has pulled four tablets from the automated medication delivery system. How many capsule(s) should the RN give? (Enter numerical value only. If rounding is necessary, round to the whole number.) 2 D/H x V =X 40/20 x 1 tablet = X 2 capsules The next day, the nurse manager of the clinic plans a staff meeting with the nurses and UAPs to communicate some changes in the scheduling protocol for the client. Which method for scheduling the staff meeting allows for the best continuity of care for the clients and the best communication between management and employees? Schedule two meeting times during the day to allow the nurses and UAPs to attend one of the sessions and maintain continuity of care in the clinic. The nurse manager conducts the meetings and presents two different protocols for scheduling. The staff nurses and UAPs vote on the two different options. The nurse manager demonstrates which type of leadership by allowing the nurses and UAPs to vote on the staffing protocol? Participant The participative style of leadership is usually the most effective, but there may be times when other styles are more appropriate. In which situations should a directive leadership style be used by the charge nurse? When dealing with a mass casualty situation. When implementing policy changes at an organizational level. During the staff meeting, the nurse manager asks the nurses and UAPs to provide feedback about the daily operations of the clinic. One of the FT RN states, "I am always assigned the most challenging clients in the clinic, and it isn't fail." How should the nurse manager respond? "I hear your concern. Please elaborate on that." After hearing the RN's response, the nurse manager schedules a one-on-one meeting with the RN to investigate the issue. After the meeting, one of the PNs tells the nurse manager that there is reason to believe one of the nurse practitioners is stealing narcotics. What action should the nurse manager take first? Have the PN describe the situation to include specific observations of the nurse practitioner's behavior. The nurse manager investigates and determines that five vials of morphine sulfate were removed from the automatic drug dispenser using the nurse practitioner's login identification, but no clients had prescriptions for morphine on this shift. Which approach should the nurse manager use to confront the nurse practitioner? Privately meet with the nurse practitioner and inform her that she was observed placing narcotics in her pocket. The charge nurse asks Ms. Washington what happened to Billy. The grandmother states that Billy fell out of his swing and that she thinks he broke his arm, but he is not crying and is currently playing with a toy car. Which action should the charge nurse take first? Ask the grandmother if she is Billy's legal guardian. Billy's grandmother states that she is the child's legal guardian, and she gives her consent for him to be treated. The RN asks Ms. Washington if she has any proof of legal guardianship for Billy. Ms Washington shows the charge nurse her custody paper for Billy. The charge nurse assigns a male RN with 5 years pediatric experience to care for Billy. Under which circumstance can healthcare personnel treat a child even when the legal guardian cannot be contacted? When the child is experiencing a life-threatening condition. The RN helps Billy take off his shirt and notices that he has bruises in multiple stages of healing on his back. The nurse asks Billy how he got the injuries, and Billy says, "I don't know." The grandmother states, " He falls a lot." Which action should the RN take first? Continue with the nursing assessment. The HCP calls the grandmother out of the room to ask her a few questions while the RN interviews Billy alone. When asked again about his injuries, Billy says his mother gets mad sometimes when he is not good. When the RN reports Billy's statements tot he HCP, the HCP states, " I have known this family for a long time and I do not believe what the child is saying." Which action should the RN take? Request that the HCP withdraw from the case. Nurse managers have many responsibilities. One of those responsibilities is ensuring the Emergent Care Clinic's performance improvement (PI) plan is implemented. How should nurse managers use PI programs? Determine root cause of errors in practice. Implement and follow guidelines established by accrediting agencies. Conduct chart reviews to determine the impact of nursing care on patient safety and healthcare outcomes. As part of the PI plan, the nurse manager reviews trends in client satisfaction surveys. It is noted that 76% of clients are dissatisfied with the amount of time they had to wait in the waiting room. Which action should the nurse manager take first? Conduct a study to determine the current average wait time. The nurse manager conducts a time study and determines that the average wait time for clients is 55 minutes before being admitted to a room in the Emergent Care Clinic. After the nurse manager decides to conduct a root cause analysis on lengthy wait times, which action should be implemented? Retrospective review of data to determine the cause of the problem. The nurse manager plans to ensure a smooth transition and continuity of care for all clients when the clinic purchases a computerized data system for billing, charting, and medication administration. Which strategy should the nurse manager use with the staff to provide a smooth transition when implementing a computerized data system? Explain that the new system will drastically decrease duplication of paperwork and streamline processes and include potential disadvantages. Majority of the staff agrees that an electronic data system will allow them to make more efficient use of their time and improve client satisfaction. The system is purchased for all departments in the Emergent Care Clinic. After the education and training on the use of the electronic data system has been completed with the staff, which implementation strategy provides the best continuity of care to the clients? Schedule implementation for each department on