A nurse is giving a presentation about client confidentiality to a group of newly licensed nurses. 4. a. Which of the following actions should the nurse take? 2. The second client that needs to be seen by the nurse is the client having weakness, a sign of hypoglycemia. Incorrect: It is out of the UAP's scope of practice to administer medication. b. d. Remove tea and coffee from meal trays, b. 8. 2. a. A nurse who is breastfeeding her 4 month old. 3. Correct: The LPN has the right to refuse a delegated intervention that is not within the scope of practice for the LPN. However, providing care for missing teeth would also be within the LPN scope of practice. Which task is appropriate for the nurse to delegate to the experienced nursing assistant? 2. Remember, pick the killer answer first! It's just not the right time for me to do this 2. 3. Suggest splitting the shift with another nurse. A nurse is discharging a client who has come to the outpatient clinic with an ankle sprain. The RN with 5 years' experience in the Labor and Delivery unit. The body needs vitamin B12 to make red blood cells. Pain 1. b. Dons gloves to empty a urinary drainage device 4. A client with an above the knee amputation reporting phantom pain. b. I can detect the presence of carbon monoxide by a metallic odor a charge nurse is making client care assignments for the day. c. Hallucinations at the onset of sleep a. 4. The partner relates her concerns about her spouse abusing alcohol and having difficulty maintaining employment. A client with COPD complaining of shortness of breath on exertion. a. Place the client in a lateral position Initiative vs guilt Which of the following actions should the nurse take? Serve food that have a hot/cold balance 2. 4. 1. Keep the drainage bag at the level of the bladder c.) Use the clean technique to collect a specimen from the drainage system d.) It also helps the client deal with issues that are important to him), 19. Assist a client to ambulate using a gait belt. Which of the following is a characteristic of men that the nurse should consider when beginning the nurse-client relationship? 212 Complete blockage of the large intestine. 4. Where on the body is each type of skin found? 2. b. Wash the tablet off with alcohol and place it in a clean medicine cup Which referral would most likely be appropriate for the nurse to make? d. Apply antiembolic stockings, d. I will place a bath seat in my shower to use when I bathe, 44. d. Do you think crying will help? Incorrect: Although this action appears to be opening lines of communication, the nurse manager is actually fostering animosity in a situation where the outcome is already predetermined. 5. 4. As the evening progressed, the unit tasks became very demanding and the nurse had to delegate several actions to the UAP. There is a trailing zero after the prescribed dose. A client diagnosed with rheumatoid arthritis needing discharge teaching. b. Irrigate the wound with an antiseptic prior to obtaining the specimen Each state BON differs in that also some have treatment programs they administer themselves. 1. Incorrect: When a unit is very busy, the nurse should rely on the UAP if the person is competent to perform the tasks. Lumbar puncture reporting a headache. Incorrect: First, the local news does not necessarily have the most accurate information on the disaster. They are more direct when discussing issues (men focus on issues and discuss them more directly and readily than women do), 20. Call the client's provider What is the best first action for the nurse to take in order to achieve this goal? The client is apparently stable and does not require any advanced assessment skills or specialized care. Functions as the hemodialysis team leader in the provisionof chronic hemodialysis care and treatment. Point out inconsistences in the client's behavior There are a total of 10 adult clients. 5. c. Make sure the client has an intake of 2,000-3,000 mL of fluid/day Did the words diabetic neuropathy make you think that a LPN should not be assigned to this diabetic? Notify the surgeon that the client wishes to withdraw informed consent for the procedure A nurse in a clinic is caring for a client who reports pain, crepitus, and a popping sound is his temporomandibular joint. A post-cardiac catheterization needing assistance with bedpan. 9. The nurse would then start the 24 hour urine once the 1st void has been discarded. It is quicker to administer medications intravenously in the hospital Notify the charge nurse of the observations. The charge nurse on each unit needs to prepare a list of possible discharges or transfers to be given to the appropriate primary healthcare providers for further action. Teaching insulin self administration cannot be delegated to the LPN. Select all that apply It results in an exchange of ideas, problem solving expression of feelings, decision making, and personal growth). A nurse is caring for an older client who states, "I am afraid that I may fall while walking to the bathroom during the night." It's unfortunate that I have to be in the hospital for this treatment (TENS units are portable; they can be used at home), 45. The third client that should be sent back for treatment is the female client stating she has been raped. The last client would be the one needing dietary education. 4. 1 A copy of select parts of the medical recording, according to facility policy, is another form of communication that will support continuity of care. Talk to each nurse about concerns related to assigned clients. d. Motor impairment, 84. Although this will require assessment, this client is not the priority at this time. The first client the nurse needs to assess is the elderly client admitted 30 minutes ago with reports of constipation for four days. What would the approximate meaning of photoelectric be, based on these root words? d. Anger, b. Open communication and brainstorming sessions in which staff can freely share thoughts or ideas creates a positive work environment while helping decrease dissatisfaction. The LPN should refuse the intervention. _____The house that we lived in for nine years has been sold. A nurse is working with an LPN to care for a client who is receiving a continuous IV infusion. 6. Report from the night shift nurse for one client included the recent development of the following findings: BP 150/100, proteinuria, severe headache, blurred vision, and abdominal pain. 1. Elevating the head of the bed 30- 40 for the client post thoracotomy a. Incorrect: This is doing research, which requires the research process be implemented, including appropriate approval. Use double bagging to remove soiled linen from the client's room They are likely to wait for others to initiate conversation Pointing to the two glasses partially filled with water, the magician asked, "Which glass contains the least water?". A nurse is preparing a client's evening dose of risperidone when the tablet falls on the countertop. Which of the following actions should the nurse take? 1. The client attempted to climb over the side rails and fell A charge nurse is making assignments for an oncoming shift. 1. A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding herself using adaptive devices. Have another nurse finish preparing the medications The nurse considers various ideas submitted by team members. b. Determine the client's level of fluency in his primary language (it is important to determine the client's level of fluency in her primary language and the nurse's language to provide teaching the client can understand). 1. Give magnesium citrate 296 mL at 3 PM today. Which nurse should be assigned to care for this client? Client #1 has COPD, and, although complaining of shortness of breath, that is not unusual for clients with this diagnosis. 1., 2., 3., & 4. Which of the following statements should the nurse identify as an indication that the client needs further teaching? Which tasks should the charge nurse delegate to the nursing assistant? Draining of the bag is a routine toileting procedure for the colostomy client and.is within the scope of practice for the UAP. c. Industry vs inferiority Incorrect: Passive ROM is performed with paralysis and can be delegated to the UAP. Select all that apply. 3. Correct: If suspicious behavior occurs, it is important to keep careful, objective records. d. Complete an incident report, 70. 1. a. I'll apply ankle to my ankle today and tomorrow b. A home health nurse is conducting a home safety assessment for an older adult client. There will likely be both physical and emotional injury that needs attention, which places this client third. The supervisor can only send one LPN/LVN to the floor. Since this is a postoperative client, It is important that the vital sign measurement is accurate to detect any changes or possible complications. Correct: The only procedure listed that is within the LPN/LVN's practice range is changing the colostomy bag. a. a. Which task would be appropriate for the nurse to assign to an LPN/VN? 2. Correct: The LPN is being floated to a specialty floor and appropriate assignments would include clients who are stable. a. Correct: The nurse has not been able to determine the skill of vital sign assessment for this new UAP. Incorrect: The RN is responsible for teaching. c. Lock the medication in a room and finish preparing it after returning from the emergency The charge nurse is determining morning care assignments for several elderly clients awaiting discharge to an assisted living facility, including a client on bed rest with a skin tear and hematoma from a fall 5 days ago. 1. They have found my address and are coming for my family!" Monitor for GI upset 30 minutes after meals. 2. Which of the following statements should the nurse identify as an indication that the client understands the discharge information? a. Which of the following actions should the nurse take? Prior to shift report, the charge nurse is making assignments for the nurses on the shift. b. (Sclect all that apply) A. Bathe a client who had an amputation 2 days ago. Accept assignment, documenting personal concerns regarding work conditions. Correct: Hot water may damage dentures so intervention is needed. Complete a client assignment sheet for the oncoming staff. This client would not be a priority to be seen before assessing the client with the cast that is too tight who may be developing compartment syndrome. 4. (c) Ba2+(aq)+CO32(aq)BaCO3(s);K=3.8108\mathrm{Ba}^{2+}(a q)+\mathrm{CO}_3^{2-}(a q) \longrightarrow \mathrm{BaCO}_3(s) ; K=3.8 \times 10^8Ba2+(aq)+CO32(aq)BaCO3(s);K=3.8108 A nurse enters an older adult client's room to insert a saline lock. You would be jeopardizing the limb of this client to take the time to do discharge teaching for the client waiting to go home. What action should the nurse implement first to ensure client safety? If the client is unstable, the nurse would retain the role of measuring the vital signs. 3. Which of the following pieces of PPE should the nurse remove first? Correct: Nurses must immediately report all client care issues, concerns or problems to the supervising nurse, the primary healthcare provider and/or the performance improvement or risk management department. 1. Before administering a feeding, the nurse should measure the gastric residual for which of the following purposes? The client is considered unstable until assessed by the nurse. Alcohol consumption increases the use of folates, and the alcoholic diet is usually deficient in folic acid.
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