CH 3: Prioritization and Time Management Flashcards
A nurse receives report on four clients. Which client should the nurse assess first?
A. A client with chronic obstructive pulmonary disease (COPD) who has a PaO2 of 88 mmHg
B. A client who is post-op day 1 from an appendectomy and reports a pain level of 7/10
C. A client with heart failure who gained 4 pounds in 24 hours and is experiencing dyspnea
D. A client with type 2 diabetes mellitus with a blood glucose of 185 mg/dL
C. A client with heart failure who gained 4 pounds in 24 hours and is experiencing dyspnea
Rationale: Sudden weight gain and dyspnea indicate worsening heart failure, requiring immediate intervention to prevent respiratory distress and potential pulmonary edema.
A nurse is prioritizing care for multiple clients. Which principles should the nurse apply? (Select all that apply.)
A. Address systemic issues before local issues
B. Prioritize chronic conditions over acute conditions
C. Treat actual problems before potential problems
D. Address airway, breathing, and circulation first
E. Prioritize stable clients before unstable clients
A. Address systemic issues before local issues
C. Treat actual problems before potential problems
D. Address airway, breathing, and circulation first
Rationale: Systemic issues take precedence over local issues, actual problems are addressed before potential ones, and ABCs (airway, breathing, circulation) are the highest priority.
A nurse is managing care for four clients. Which task should the nurse complete first?
A. Administer pain medication to a post-op client who rates pain as 8/10
B. Suction secretions from a client with a tracheostomy who has audible gurgling
C. Educate a newly diagnosed diabetic client about insulin administration
D. Reposition a bedbound client to prevent pressure ulcers
B. Suction secretions from a client with a tracheostomy who has audible gurgling
Rationale: Airway clearance is the highest priority (ABCs). Suctioning is necessary to prevent airway obstruction and respiratory distress.
A nurse is planning care for four clients. Which client should be assigned to a licensed practical nurse (LPN)?
A. A client receiving IV heparin with an aPTT of 95 seconds
B. A client requiring a new nasogastric tube insertion
C. A client receiving discharge education about a newly prescribed medication
D. A client with pneumonia needing a nebulizer treatment
D. A client with pneumonia needing a nebulizer treatment
Rationale: LPNs can administer medications and perform treatments such as nebulizer therapy. IV anticoagulation, NG tube insertion, and patient education require an RN.
Which strategies should the nurse use to effectively manage time? (Select all that apply.)
A. Delegate tasks when appropriate
B. Plan care based on the needs of the most vocal client
C. Group similar tasks together
D. Focus on one task at a time to avoid distraction
E. Anticipate potential interruptions and plan accordingly
A. Delegate tasks when appropriate
C. Group similar tasks together
E. Anticipate potential interruptions and plan accordingly
Rationale: Effective time management includes delegation, combining tasks, and anticipating interruptions to stay efficient.
A nurse is caring for four clients. Which client should be seen first?
A. A client who is 24 hours post-op from a total knee replacement and requests pain medication
B. A client with pneumonia who has an SpO2 of 89% on room air
C. A client receiving IV antibiotics who needs a new IV started
D. A client with atrial fibrillation who is due for a warfarin dose in 30 minutes
B. A client with pneumonia who has an SpO2 of 89% on room air
Rationale: Oxygenation issues are a priority. An SpO2 below 90% indicates hypoxemia, which must be addressed promptly.
A nurse is making rounds and finds a client diaphoretic, confused, and with a blood glucose of 42 mg/dL. What is the nurse’s priority action?
A. Administer 15 g of oral glucose
B. Notify the healthcare provider
C. Recheck the blood glucose in 30 minutes
D. Document the findings
A. Administer 15 g of oral glucose
Rationale: The client is experiencing symptomatic hypoglycemia, which requires immediate treatment with fast-acting glucose to prevent further complications.
Which interventions can help a nurse avoid time-wasting activities? (Select all that apply.)
A. Using checklists to stay on track
B. Documenting at the end of the shift to maximize patient care time
C. Communicating clearly with team members
D. Planning ahead for medications and procedures
E. Avoiding delegation to maintain control of tasks
A. Using checklists to stay on track
C. Communicating clearly with team members
D. Planning ahead for medications and procedures
Rationale: Checklists, clear communication, and planning ahead improve efficiency.
A nurse is caring for four clients. Which client should receive care first?
A. A client with asthma who has an expiratory wheeze
B. A client with end-stage renal disease who reports mild nausea
C. A client with a chest tube who had 50 mL of drainage in the last hour
D. A client who had a thyroidectomy and is experiencing stridor
D. A client who had a thyroidectomy and is experiencing stridor
Rationale: Stridor indicates airway obstruction, which is life-threatening and requires immediate intervention.
A nurse is managing multiple complex patients. Which intervention is best?
A. Prioritize systemic issues before local issues
B. Treat stable clients first to complete more tasks
C. Administer all medications at the beginning of the shift
D. Always delegate care to unlicensed assistive personnel
A. Prioritize systemic issues before local issues
Rationale: Systemic issues affect overall client stability and require immediate attention before addressing local issues.
Which clients should the nurse see first? (Select all that apply.)
A. A client with a blood pressure of 85/40 mmHg
B. A client with a potassium level of 3.7 mEq/L
C. A client with a heart rate of 48 bpm and dizziness
D. A client with a stage 2 pressure ulcer
A. A client with a blood pressure of 85/40 mmHg
C. A client with a heart rate of 48 bpm and dizziness
Rationale: Hypotension and symptomatic bradycardia indicate hemodynamic instability, requiring immediate intervention.
A nurse has multiple urgent tasks. What should the nurse do first?
A. Delegate all tasks to nursing assistants
B. Address life-threatening conditions first
C. Administer medications before assessing clients
D. Complete tasks in the order received
B. Address life-threatening conditions first
Rationale: Life-threatening conditions, such as airway and circulation issues, must always be prioritized.
Which are key components of successful delegation? (Select all that apply.)
A. Right task
B. Right person
C. Right communication
D. Right supervision
all of the chices are correct
Rationale: Effective delegation requires ensuring the right task is assigned to the right person with clear communication and proper supervision.
Which task should be completed first during shift change?
A. Assess unstable clients before reviewing documentation
B. Gather supplies for the day
C. Review medication orders
D. Check emails
A. Assess unstable clients before reviewing documentation
Rationale: Unstable clients need immediate assessment before administrative tasks.
