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A nurse identifies a pressure ulcer after a client had a long, extensive recovery following a surgical procedure. Initiative vs guilt 4. Incorrect: This is appropriate because this position will improve gas exchange and breathing for a client after thoracic surgery. b. Irrigate the wound with an antiseptic prior to obtaining the specimen 2. Schedule visiting times in two-hour increments so clients are not overwhelmed. The nurse should do this when repositioning is needed. Sit side-by-side with the client What is the best care assignment for this client? It is not a routine task. c. Irrigating a client's abdominal wound This client is stable and predictable. b. This perceived lack of control can create distrust and frustration among personnel, ultimately impacting client care. Obtain a urine specimen from a client with an indwelling Foley catheter. a. Reposition the client every 3 hr Some general guidelines are necessary, with input from clients and family to individualize any special requests with assistance from the facility. b. Assigning tasks to an AP e. Feed a client who had a stroke 3 months ago, 32. The RN is assigned to care for an unemployed 26-year-old woman, newly diagnosed with acquired immunodeficiency syndrome (AIDS). 2. Client who has multiple injuries from a motor vehicle accident. Total abdominal hysterectomy, bladder suspension with A&P repair, client with breast reduction. b. d. Reduced blood viscosity, a. Auscultating heart sounds Which of the following sites should the nurse plan to use to obtain the blood specimen? b. Wash the area of the puncture thoroughly with soap and water 4. It would not be appropriate to overload this new employee with extra work. b. Wash the tablet off with alcohol and place it in a clean medicine cup A written report of the incident is completed by the nurse and turned into the appropriate person (generally the performance improvement department). d. Establishing the client's secondary medical diagnoses, b. 6. We do not know the extent of her injuries based on what the option tells us. Remember, pick the killer answer first! c. Review another client's similar surgical experience d. Routine acquisition of a urine specimen 1. 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. a. Auscultating heart sounds Incorrect: Just because the UAP is able to accomplish all daily assignments efficiently does not mean more work could be handled as effectively. 1. and 16 g of fat. Incorrect: The nurse is responsible for evaluating a client. The nurse asks the client, "Are you feeling anxious about the results of your colonoscopy?" Nothing life threatening. a. (Select all that apply.). 5. Dr. Frankenstein had seen himself as a(n) ?\underline{? Which tasks should the charge nurse delegate to the nursing assistant? c. Offering false reassurance a. The client was lying on the floor next to his bed (nurse should document what they actually see), 68. Assist a client to ambulate using a gait belt. Incorrect: By encouraging the client to be more cooperative, the nurse is denying the client's feelings and concerns. Based on this information,what should the nurse do? You get this vitamin from eating foods such as meat, poultry, shellfish, eggs, and dairy products. A nurse is creating a discharge plan. Incorrect: A client who has a spinal cord injury and is in rehabilitation is still alert and able to make decisions. Write N next to the nonessential clauses and E next to the essential clauses. Which task should the nurse take responsibility for completing? b. 5. The worst complication following a thoracentesis is a possible pneumothorax; therefore, the nurse should assess this client first. Pernicious Anemia Society 1. This would be out of the UAP's scope of practice. c. The restraints should promote the client's safety and prevent injuries A copy of select parts of the medical recording, according to facility policy, is another form of communication that will support continuity of care. b. 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? The client asks the nurse, "Why do I need that? 1. Incorrect: Pernicious anemia is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12. Injuries from a motor-vehicle accident can be life threatening. 1., 3, & 4. a. I'll sit with my knees lower than my hips Provides safe, effective delivery of patient care in . Therefore, the nurse with Labor and Delivery experience would be the most appropriate one to assign to care for this client who has postpartum preeclampsia. Each state BON differs in that also some have treatment programs they administer themselves. A nurse is caring for a client in a long-term facility who is receiving enteral feedings via an NG tube. Nursing questions and answers. Make nursing assignments appropriate to the skill level . Allow families unlimited visitation around the clock to meet their schedules. Sudden attacks of sleep a. Incorrect: The nurse may trust the UAP; however, the nurse has not been able to determine the competency of the new staff member. 5. Incorrect: The RN is responsible for assessment and evaluation of clients. A nurse on a medical unit is caring for a client who suddenly becomes confused and drowsy. The women's health charge nurse is making assignments for the next shift. b. I'll use the cleansing wipes from the front to back 4. When completing an incident report about the pressure ulcer, the nurse should take which of the following actions? When the licensed person cannot determine this, the task should not be delegated. Witness the client's signature (verify that the client is consenting to voluntarily and appears to be competent to do so), 71. A client receiving heparin injections for deep vein thrombosis. What actions should a nurse take to provide continuity of care when discharging a client diagnosed with hemiparesis to a long-term care facility for rehabilitation? Because a scope is inserted through the urethra for this procedure, the client may experience burning or frequency immediately following this test. Incorrect: The RN is responsible for assessment and evaluation. But the evidence-based care leaders are trained to help nurses through the proper process of evidence based research. Wears a gown when entering the room of a client who requires contact precautions A nurse is orienting a newly licensed nurse about documentation of a client's information in the electronic health record. 1. 2. Currently, your census is 11, with one empty bed. d. I will place a bath seat in my shower to use when I bathe, b. This could be devastating to the client if the decimal point is missed and the client receives 200 mg instead of the intended 20 mg of lisinopril. Incorrect: If alcohol or drug dependency is suspected, confrontation will result in hostility and denial. PURPOSE AND SCOPE: Supports FMCNA's mission,vision, core values and customer service philosophy. 2. 1. A nurse is assessing a client who is experiencing prostatic hypertrophy. 2. A nurse is caring for a client who expresses anxiety about his impending surgery. c. Malpractice Client scheduled for breast reconstruction after mastectomy. c. Decreased sodium excretion Vital sign measurement c. Changing a dressing c. Palpating for pedal edema b. The below statement corresponds to a numbered sentence in the passage. Correct: Documentation of the client's baseline functional status is important for the receiving facility to work with in further goal setting. 6. If a sentence is already correct, write CCC. 3. 4. A nurse accidentally sticks her hand with a syringe needle after administering an IM injection to a client. 76. Secondly, staff will be far too busy to watch television or listen to the radio with all the activity occurring hospital wide. 2. Protective 4. Which of the following nontherapeutic communication techniques is the nurse using? A newly licensed nurse is seeking advice from her preceptor about the need to purchase personal professional liability insurance. Client eating a simple-carb snack due to weakness. 2. 1. A client with a fractured right humerus who reports the cast is too tight. A nurse is having difficulty caring for a client due to variables affecting the communication process. Return any fresh linen not used for a client to the linen supply area A nurse is providing care to a client who is on strict bed rest following surgery. 1. Client diagnosed with hemorrhoids who had some spotting of bright red blood on toilet tissue with last bowel movement. 10. 1., 4., & 5. 5. a. Clarifying c. imaginary c. Contact the provider to question the dosage (when a nurse believes there is an error in a prescription, the nurse must question the provider). The spouse can rescind the Advance Directive if the client becomes unresponsive. 3. The client is reporting anxiety, discomfort, and a feeling of bloating. 3. The nurse did not trust the new UAP. d. Breathing in carbon monoxide can cause headaches and nausea, c. Take the client to the bathroom every 2 hr (this establishes a regular pattern of toileting and the client learns to trust that the staff will place value on his bladder-training needs), 59. 1., 2., 3., & 4. This service focuses on teaching the primary caregiver to meet the client's needs An experienced nurse would be assigned to this unstable client due to the possibility of a reoccurring hemorrhagic stroke resulting from the client's hypertension. e. Suctioning a client's new tracheostomy tube, d. Your provider has prescribed antibiotic therapy to be administered intravenously every 6 hours, 94. c. Do not eat or drink anything the morning of the test a. d. Counting radial pulse b. d. Explain oral hygiene to a client receiving chemo d. Test the pH of gastric aspirate, d. Determine if the client uses hearing aids, 86. Explain administration is demanding a decreased overtime. 1. Ask the float nurse, "Have you been drinking?" 3. Temporary urinary retention A nurse has just finished a wound irrigation for a client who requires contact precautions. 1., 2., 4., & 5. 4. Ambulating a client who is 2 days post vaginal hysterectomy Alert all off-duty personnel to stand by in case of call- in. Which preoperative prescription should the nurse question? Which of the following actions should the nurse take? Which group of clients should she assign to the medical surgical nurse? c. Hold an object away from her body as she lifts it d. Arrange the food groups clockwise on the client's place, b. I'll use the cleansing wipes from the front to back, 51. Suggest splitting the shift with another nurse. The charge nurse on the postpartum unit is making assignments. Additional data includes pulse 100/min, RR 24/min, BP 124/76 mm Hg, and temp 36.8C (98.2 F). 1. Which of the following communication techniques should the nurse use during this phase? Even though the client is a child, superficial burns require only dry sterile dressings and possibly oral pain medication, both tasks which are within the scope of practice for an LPN. Which of the following actions should the nurse include in the plan? c. Physical therapist b. 4. They are more direct when discussing issues (men focus on issues and discuss them more directly and readily than women do), 20. c. Open the right flap with the left hand Assist the float nurse with the clients case. c. Provide the client with a diet high in protein Which task would be appropriate for the nurse to assign to the unlicensed assistive personnel (UAP)? a. 1. e. Time, c. The nurse may serve as a witness to informed consent for organ donation (nurses may witness the consent for organ donation after a specially trained professional requests consent), 23. the nurse responds, "don't worry, no one will harm your family." Incorrect: While it is true that the nurse manager is ultimately responsible for implementing and announcing new schedule changes, doing so without any staff input can create discontent in the work environment. Based on these findings, to which of the following providers should the nurse request a referral for the client? Notify the board of nursing (BON) that the float nurse is an alcoholic. Communicates with the physician and other members of the healthcare team to interpret, adjust, and complete patient care plans. Which of the following methods should the nurse plan to use? Increased insulin production b. Incorrect: The wash cloth is placed in the sink to prevent the dentures from breaking if they are dropped. The word or phrase that you choose must express roughly the same meaning as the italicized word in the passage. Making client care assignments As the RN charge | Chegg.com Science Nursing Nursing questions and answers Making client care assignments As the RN charge nurse, you are preparing to make assignments for the oncoming shift in the medical-surgical unit. Client #3 is receiving heparin sub-q for deep-vein thrombosis, and sub-q injections are within the LPN's scope of practice. Assess personal level of fatigue prior to making a decision regarding accepting or refusing assignment. Therefore, this client would not be a priority over a client who may be experiencing a MI. Personal liability coverage is not mandatory, but you should consider purchasing your own coverage, 87. Include any relevant statements the client made about the ulcer, 64. a charge nurse is making client care assignments for the day. Try different methods of oral care on unresponsive clients to see what works best. The key word in the stem is first. Nothing by mouth (NPO). d. Put the side rails up and tell the client to call the nurse before voiding, d. Two nurses using a friction-reducing device (reduces the risk of injury to the nurses and to the client; nurses can use a draw sheet as a friction-reducing device), 38. 4. a. Evaluate pain relief after narcotic administration. A charge nurse is making client care assignments. c. Washes and rinses her hands for 10 seconds Dentures should be stored in a denture cup. Those residing in long term care facilities benefit greatly from time spent with family or even older friends. This situation requires an immediate neurovascular check to determine if intervention is needed to relieve the pressure and restore circulation. Which of the following statements by the newly licensed nurse indicates understanding of the purpose of documentation? Which nurse should be assigned to care for this client? In the following sentences, circle each incorrectly used lowercase letter. Therefore, this would not be the most appropriate nurse to assign to this client. Correct: Hot water may damage dentures so intervention is needed. The other options may be correct but are not the best first action. A client is scheduled for a colonoscopy with biopsy of a large tumor that is completely blocking the large intestine in the morning. 2. Correct: The only procedure listed that is within the LPN/LVN's practice range is changing the colostomy bag. Electric comes from the Latin word for amber, a substance which readily takes a static electric charge. Which of the following infection-control precautions should the nurse use caring for this client? Incorrect: The first void of a 24 hour urine is discarded and can be delegated to the UAP. 2. a. This situation is considered an external disaster which means the hospital will be expecting multiple victims. 1. c. Holds the soiled linen against her body while carrying it to the linen bag The stem does not indicate any loss of neurological function resulting from the seizure activity. 3. a. The charge nurse is making client assignments for a neuro-medical floor. Invite staff to contribute ideas on scheduling changes. 1. a. The abdominal pain is worsening. d. Let's wait until tonight to see if he continues his behavior, 63. 5. a. A nurse has completed an informed consent form with a client. Restock pediatric patient care rooms with oral rehydration fluids using a standardized check list., The charge nurse is preparing the patient care assignments for the day shift, assigning clients to a LPN/LVN and a certified nursing assistant (CNA). If the client is unstable, the nurse would retain the role of measuring the vital signs. The last client would be the one needing dietary education. & 4. a. I will keep spare crutch tips handy 2. The nurse should call for immediate help so that a safe care environment is maintained for all clients. Teaching is not in the role of the LPN and therefore, this client would need to be assigned to the RN, not the LPN, for the teaching needs of the client. Photo comes from the Greek word for light. A client requesting assistance packing his belongings for discharge later today.. Which of the following info should the nurse include? 1. (Select all that apply) 4. Which of the following findings indicates that the client is meeting this goal? b. 1. It also helps the client deal with issues that are important to him), 19. 4. It is the nurse's responsibility to communicate the client's condition and care plan to the receiving facility nurse in order to support continuity of care. Start MgSO4 at 3g/hr IV (a) HCN(aq)+H2O(l)H3O+(aq)+CN(aq);K=4.91010\mathrm{HCN}(a q)+\mathrm{H}_2 \mathrm{O}(l) \longrightarrow \mathrm{H}_3 \mathrm{O}^{+}(a q)+\mathrm{CN}^{-}(a q); K=4.9 \times 10^{-10}HCN(aq)+H2O(l)H3O+(aq)+CN(aq);K=4.91010 Show client who has conjunctivitis how to clean the eyes. 1. A client with COPD complaining of shortness of breath on exertion. A nurse is performing care activities for a client in the zone of touch that requires his consent. 3. The command center is the only reliable source of information and will make any decisions needed by hospital personnel. Incorrect: If a report is made to the BON, it should be a factual documentation of specific events and actions, not a statement of impairment. 2. The nurse has another priority. Which of the following should the nurse identify as an interpersonal variable? 2. Focusing c. I'll clean the inside of the container with a wipe Request that the nursing assistant obtain equipment for the client's care while the RN talks with the client and the family. d. Talk with others who have info about the client, b. I can detect the presence of carbon monoxide by a metallic odor, 58. A charge nurse is planning client activities for the day. Demonstrate principles of collaborative practice within the nursing and healthcare teams fostering mutual respect and shared decision-making to achieve stated outcomes of care. 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 last client that should be sent back for care is the client experiencing epigastric pain and nausea after eating. Which task would be appropriate for the nurse to assign to an LPN/VN? b. I'll do exercises that strengthen my abdominal muscles When reviewing the admitting prescriptions for a client, the nurse notes that the dose of one medication is three times the usual dose of this medication. 3. PURPOSE AND SCOPE: Functions as the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Which task would be appropriate for the nurse to assign to an unlicensed assistive personnel (UAP)? Identify and assess each incoming client. 3. However, since the new UAP's competency level is not known, the nurse does not delegate this task for the safety of the client. b. Donation costs are the responsibility of the donor's family and estate