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2. A client diagnosed with rheumatoid arthritis needing discharge teaching. There are potential problems in Options #1, 2, 3, and 4 and should be questioned and corrected. 1., 2., 3., & 4. Correct: Assisting clients with activities of daily living are within the UAPs scope of practice. LPNs can provide the client with needed analgesics or may simply guide the client with diversional activities for managing this type pain. a. The RN with 5 years' experience in the Labor and Delivery unit. The charge nurse is responsible for ensuring that the patients on the unit are properly cared for in a safe and efficient manner. A charge nurse is making client care assignments. a. Each state BON differs in that also some have treatment programs they administer themselves. The client with chronic emphysema has expected shortness of breath. 4. Place the client in low Fowler's position Narrative interaction (involves asking a client to share personal stories so the nurse can better understand the context of a client's life in the working phase of a nurse-client relationship), 47. Alert all off-duty personnel to stand by in case of call- in. Select all that apply Donning gloves and using a gauze pad to grasp and remove dentures Client with an oral temperature of 103.2 F (39.5 C) 36 hours post intracranial surgery. d. I shouldn't advice you about what is ultimately a personal decision, b. Which of the following instructions should the nurse include? Which response by the LPN is appropriate in response to the inappropriate delegation? There are a total of 10 adult clients. 4. Administer tap water enemas until clear at 6 AM. Which of the following actions should the nurse take? Client reporting epigastric pain and nausea after eating. 1. However, there are some basic points which are standard among all facilities. Document what the nurse believes was the cause of the ulcer development A nurse working on the pediatric oncology unit is beginning the shift and has received report which included some new laboratory data for the clients. Incorrect: The client will need IV access for sedation during the procedure and will need the fluid for hydration since the client is NPO. 1., 2., & 5. As a charge nurse, you're a frontline leaderthe first reflection of your organizationand you need to ensure you are meeting the organization's goals and values. Which of the following statements should the nurse identify as an indication that the client understands the discharge information? Which of the following approaches should the nurse use when using confrontation? Client diagnosed with hemorrhoids who had some spotting of bright red blood on toilet tissue with last bowel movement. Which nurse should be assigned to care for this client? 2. A nurse is working with an AP while caring for a surgical client who is 1 day postoperative. Limit the client's fluid intake in the evening Incorrect: The RN is responsible for assessment and evaluation of clients. The spouse can rescind the Advance Directive if the client becomes unresponsive. The charge nurse knows what client would be most appropriate for this LPN? The critical care nurse is caring for a client with a head injury secondary to a motorcycle accident who, on morning rounds, is responsive to painful stimuli and assumes decorticate posturing. Which of the following types of torts has the nurse committed? 6. *HURST REVIEW Qbank/Customize Quiz - Manageme, *HURST REVIEW Qbank/Customize Quiz - Adult He, *HURST REVIEW Qbank/Customize Quiz - Basic Ca, *HURST REVIEW Qbank/Customize Quiz - Fundamen, ***HURST REVIEW NCLEX-RN Readiness Exam 1***, The Language of Composition: Reading, Writing, Rhetoric, Lawrence Scanlon, Renee H. Shea, Robin Dissin Aufses, Edge Reading, Writing and Language: Level C, David W. Moore, Deborah Short, Michael W. Smith. Only the state Board of Nursing can legally determine the LPN's scope of practice. b. Which of the following findings reported by the LPN indicates to the nurse the client has phlebitis at the IV insertion site? 208 Which clients could be assigned to an LPN? b. Massage any bony prominences to promote circulation A client with an above the knee amputation reporting phantom pain. 1. The nurse should use close-ended questions when assessing which of the following factors? A client with fibromyalgia reporting generalized pain of 7 out of 10. b. Verbalize understanding of how the client feels Right forearm What client should the nurse assess first? 2. Cleanse the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen (nurse should remove all wound exudate and any residual antimicrobial ointment or cream to avoid altering the culture results), 56. During lunch, Robin jotted a letter to Amy and signed it, "your friend, Robin.". b. 2. The charge nurse's best response is to first obtain the needed information to make the best decision. Select all that apply 3. A written report of the incident is completed by the nurse and turned into the appropriate person (generally the performance improvement department). c. Foot Incorrect: Restricting visitation to two hours is not appropriate, particularly for families traveling long distances to visit a client. The nurse is caring for four clients. 4. Write the letter of your choice on the answer line. c. Respite care helps relieve pain and promote comfort Which of the following actions should the nurse take? d. Expect minor discomfort after the procedure, b. I will come back later and we can talk (offers herself to client which encourages open communication). 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. A nurse accidentally sticks her hand with a syringe needle after administering an IM injection to a client. One nurse lifting as the client pushes with his feet Assign a nursing assistant to help the client with self-care activities. The RN with 10 years' experience pulled from the ER. I am feeling much better since my discharge from the hospital and I think my kidneys are working again." Relax her abdominal muscles when she lifts an object 4. 4. A nurse is working with an LPN to care for a client who is receiving a continuous IV infusion. An adolescent client post appendectomy reporting pain. Covering open wounds will help to decrease bacterial exposure until the registered nurse or primary healthcare provider can assess and treat each wound. A 10 year old school-age child would also be more cooperative, making it easier for the LPN to interact with that client. 1. Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. 2. a. a. I'll sit with my knees lower than my hips Since the enema would clean below the obstruction, the client would be able to expel the enema and any feces in this part of the colon. Symbolic communication This situation is considered an external disaster which means the hospital will be expecting multiple victims. Which of the following is a characteristic of men that the nurse should consider when beginning the nurse-client relationship? 2. A nurse enters an older adult client's room to insert a saline lock. a. Transpersonal b. Intrapersonal c. Interpersonal d. Public b. A charge nurse is planning client activities for the day. Which of the following actions should the nurse take? The client is apparently stable and does not require any advanced assessment skills or specialized care. b. I will keep the fluorescent ceiling light on in my room at night a. Focus on the client's present circumstances instead of his personal stories Correct: The client must have lost decision-making capacity because of a condition that is not reversible or must be in a condition that is specified under state law, such as a terminal, persistent vegetative state, irreversible coma, or as specified in the Advanced Directive. Each unit functions differently, but the charge nurse's role is to make the unit run smoothly. Of the following barriers to learning the nurse identifies with this client, which should the nurse interpret as a need to postpone the session? Something new could have occurred with the clients, making the assignments too heavy. Correct: The nurse manager is aware that open communication with staff is vital to increase workplace satisfaction and staff retention. Correct: Positive feedback is an effective communication tool that improves the workplace environment and encourages individual achievement, particularly in challenging situations. 2. Hearing loss What task would be appropriate for a nurse caring for a client diagnosed with gastroesophageal reflux to delegate to an unlicensed assistive personnel (UAP)? e. Feed a client who had a stroke 3 months ago, 32. Encourage client to express grief related to loss of independence. A client requesting assistance packing his belongings for discharge later today.. d. The nurse has already considered alternatives to restraints, a. A client is scheduled for a colonoscopy with biopsy of a large tumor that is completely blocking the large intestine in the morning. Ask the charge nurse to evaluate the intervention. c. Changing a dressing The client is receiving IV fluids through an IV catheter inserted in the basilic vein on the right forearm. There are a total of 10 adult clients. c. I will begin upon the client's admission to the facility American Sickle Cell Anemia Association Therefore, this client would not be a priority over a client who may be experiencing a MI. Reach around the pack and open the top flap away from the body, 53. c. 214 The last client that should be sent back for care is the client experiencing epigastric pain and nausea after eating. 1. A nurse is administering a cold therapy application to a client. nursing brain nurse sheets night documentation hour rotation sheet icu care assessment charting plan nurses assignment patient shift report rn. Correct: A LPN should be able to care for a client with arthralgia who requires pain medication on a regular schedule and is receiving warm compresses. Removing the client's dentures Functions as the hemodialysis team leader in the provisionof chronic hemodialysis care and treatment. Nurses dependent on drugs or alcohol can harm clients. Select all that apply. 6.
Fundamentals Practice Flashcards | Quizlet The client then states, "I have changed my mind and do not want to have the procedure done." 4. 1. Client to receive dietary education. 2. Collecting I & O totals for unit clients at the end of shift. A nurse is preparing a sterile field. 1.
NUR 112 Practice Assessment Flashcards | Quizlet The nursing supervisor may be able to assist with client care until another nurse can come in to work. Which of the following findings should the nurse identify as a safety risk? During exacerbation, the client will have many diarrhea stools. Ask the RN why the assignment is too heavy.
Practice Leadership Exam for Nursing - A charge nurse in an - StuDocu a. Performing passive range of motion (ROM) on the client with right sided paralysis. Speak to the UAP to determine what happened with the feeding. 4. the nurse should delegate collection of which of the following specimens to DismissTry Ask an Expert Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions Harvard University University of Georgia Maryville University Incorrect: Emergency room nurses deal with life threatening emergencies but are not specialized in the care of clients with preeclampsia. 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). Correct: First, you must recognize that this client has the signs and symptoms of postpartum preeclampsia. 5. c. Paraphrasing Keep the drainage bag at the level of the bladder c.) Use the clean technique to collect a specimen from the drainage system d.) b. A nurse asks a client how he is feeling. Which of the following client statements indicates an understanding of the procedure? Open communication and brainstorming sessions in which staff can freely share thoughts or ideas creates a positive work environment while helping decrease dissatisfaction. This client is stable and predictable. Which of the following nursing statements indicates the nurse understands when discharge plans should be implemented? These are appropriate tasks for an UAP to complete. 4. The first client, who is 1 day postoperative following a partial bowel resection, requires a dressing change, total parenteral nutrition administration and reports a pain level of 6 on a scale of 0 to 10. Briefly assess every client. Which clients should the nurse assign to the LPN/LVN based on skill level and scope of practice? The partner relates her concerns about her spouse abusing alcohol and having difficulty maintaining employment. 3. 3. This assumption is not appropriate, and the feelings and concerns of the client should be addressed. d. Have the client practice blood-glucose monitoring using a glucometer, d. When asking if the client took his medications this morning, 81. A nurse is caring for a client who has a hip fracture that requires surgical repair. Which of the following statements should the nurse make? This service focuses on teaching the primary caregiver to meet the client's needs b. Confrontation should occur in the presence of a charge nurse or supervisor. 4. 5. Receive report from the emergency department (ED) on a new client. Splitting the overtime shift is an acceptable option that the nurse could suggest in order to solve the staffing problem and decrease the amount of time the nurse will be working. Discuss the issue with the leader of the "best practices" committee. (d) AgCl(s)Ag+(aq)+Cl(aq);K=1.81010\operatorname{AgCl}(s) \longrightarrow \mathrm{Ag}^{+}(a q)+\mathrm{Cl}^{-}(a q) ; K=1.8 \times 10^{-10}AgCl(s)Ag+(aq)+Cl(aq);K=1.81010. Checking capillary refill beneath the client's fingernail As part of an annual physical examination a nurse is preparing a client to undergo a chest x-ray. Diltiazem is a calcium channel blocker that has been ordered as a titrated drip to slow heart rate and restore a regular rhythm. 2. The nurse is using which level of communication at this time? Incorrect: This prescription is written correctly. INCORRECT 3) Review a low-sodium diet for a client who has hypertension. d. Anger, b. Provide an adaptive feeding device for the client The nurse assists the patient to the bedside commode and the client sustains an injury to the operative area. Draining of the bag is a routine toileting procedure for the colostomy client and.is within the scope of practice for the UAP. Client #5 -It is considered within the scope of practice for an LPN/LVN to monitor a transfusion of a blood product. & 3. a. c. Review another client's similar surgical experience Incorrect: The client does need to be cleaned out below the tumor so that the primary care provider can see the area of concern and complete the biopsy. The client's self-report of pain severity, 88. Incorrect: Atrial fibrillation places the client at risk for blood clots. 4. Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. This center functions as 'information central', where all plans or activities are coordinated and determined by those personnel. Incorrect: The RN is responsible for collecting data. The client attempted to climb over the side rails and fell 4. The nurse should not lecture, scold or argue with the float nurse. Client diagnosed with gastroenteritis who reported 300 mL diarrhea stool x2 in the last hour. Announce the new changes at the monthly staff meeting. A nurse caring for a client is using active listening skills. The nurse has been assigned four clients. e. Throw rugs, 40. A nurse is teaching a client about the physical effects of chemotherapy. d. Identity vs role confusion, b. Assigning tasks to an AP (delegation is considered indirect care), 13. 32-36, Winningham's Critical Thinking Cases in Nursing, Final Exam Review -Missed QuestionsE5-Multi. The nurse should not assume that the UAP just did not do their job, but needs to ascertain the reason for not feeding the client. d. Counting radial pulse, 100. This is not a situation that requires the LPN to notify the primary healthcare provider. Incorrect: The wash cloth is placed in the sink to prevent the dentures from breaking if they are dropped. c. Blood-tinged urine So, now you must decide which of these high priority clients should be seen in what order. A nurse receives a client care assignment from the charge nurse that he believes is unfair. Perform the Heimlich maneuver A charge nurse is making client care assignments. 2. Ambulating a client who is 2 days post vaginal hysterectomy This stage involves constructive efforts on the part of the group members 3. a. This could cause a medical emergency. Two hours . 3. 4. Point out inconsistences in the client's behavior What options would be appropriate for the nurse to take? The client receives home health care and spends most of his day in a reclining chair. c. Discard the tablet and obtain another dose of medication 4. Elevating the head of the bed 30- 40 for the client post thoracotomy b. c. We administer all medications intravenously to clients in this unit d. I hope I don't have to take as many pain pills, d. Left forearm (allows for easy access and doesn't interfere with the IV catheter), 46. Two hours after other trays were picked up from the rooms, the nurse notes that the client's untouched tray is still at the bedside. All these clients have a GI problem. A nurse just back from maternity leave. Because facilities generally prefer some type of consistent schedule for staffing purposes, older visitation policies were often very restrictive. Incorrect: The nurse retains the responsibility for the delegated task. Twist at the waist when she moves an object to one side 2. b. Emptying a urinary drainage bag for a client who has pneumonia d. Offering sympathy, d. Test the pH of gastric aspirate (nurse should verify position of tube, testing pH is acceptable method between x-ray confirmations), 85. 3. c. Changing a dressing, 78. 1. The nurse cannot allow the UAP to perform advanced tasks. A nurse is having difficulty caring for a client due to variables affecting the communication process. a. Which of the following statements should the nurse make? What is the appropriate assignment? The charge nurse tells a nurse that multiple sick calls from the upcoming shift has occurred. The nurse has another priority. Determining the client's length of stay 1. A nurse is using the communication principle of presence when establishing a collaborative relationship with a client. 4. a charge nurse is making client care assignments for the day. 4. A nurse is teaching a client about carbon monoxide poisoning. Select all that apply. But the client does need to be assessed prior to the client with Crohn's disease who is improving. This client can wait until the others are treated. c. Nonfat milk Which of the following actions should the nurse take? Correct: The hospital nurse to client staffing ratio should reflect the complexity of nursing care for high acuity clients. Include any relevant statements the client made about the ulcer Post-surgical pain is expected and without further parameters, no determination can be made regarding this client. A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. Incorrect: Pernicious anemia is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12. c. Palpating for pedal edema 2. Incorrect: This client does not have a predictable outcome. Correct: The unlicensed nursing assistant should not turn tube feedings off or on. b. I'm so sorry to hear about this Which of the following actions should the nurse take? Which client should the nurse assess first? Check environment for potential safety hazards.
A charge nurse on an acute care unit is planning care for a client c. I'll bear weight on my ankle for 10 minutes every hour Perform range of motion (ROM) exercises at least 2-3 times daily Once the client is stable, the UAP could perform this task. 2. d. Reduced blood viscosity, a. Auscultating heart sounds If a sentence is already correct, write CCC. However, it is on the "Do Not Use" list of abbreviations because it can be confused with morphine sulfate (MSO4). Client who requires teaching about the use of a patient-controlled analgesia (PCA) pump. d. Motor impairment, 84. 4. Additional data includes pulse 100/min, RR 24/min, BP 124/76 mm Hg, and temp 36.8C (98.2 F). Use double bagging to remove soiled linen from the client's room a. Select all that apply If the decimal point is missed in this situation, the client could receive 5 mg instead of the intended dose of 0.5 mg of risperidone. Refuse the overtime assignment, being prepared for disciplinary action. 3. INCORRECT: There is no information regarding how recent was the surgery or the degree of pain being experienced. c. I will cover the catheter so he cannot see it The best practice committee utilizes current research in their recommendations. We see that the temperature is already elevated, which makes us worry that infection is present. The second client that should be given a treatment room is the elderly client who fell and fractured the left femoral neck. 4. What action should the nurse implement first to ensure client safety? c. Malpractice 1. Documentation is a communication tool for the interprofessional health care team. Witness the client's signature (verify that the client is consenting to voluntarily and appears to be competent to do so), 71. Client scheduled for a dressing change to foot ulcer. Incorrect: A UAP may not remove and change surgical dressings, which would involve assessment and further education. The nurse did not trust the new UAP. c. Shivering b. Incorrect: It is out of the UAP's scope of practice to administer medication. 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. 2. a. When completing an incident report about the pressure ulcer, the nurse should take which of the following actions? c. To determine the client's electrolyte balance Gathering needed equipment and supplies is within the scope of duties for the UAP. b. Remind the client to tell the nurse when he has to urinate Convenience for the nursing staff or the client's family 1. Incorrect: First, the local news does not necessarily have the most accurate information on the disaster. Which of the following actions should the nurse perform when opening the sterile pack? a. To confirm the placement of the NG tube Select all that apply The area surrounding the insertion site feels warm to the touch A home health nurse is conducting a home safety assessment for an older adult client. c. Do not eat or drink anything the morning of the test Incorrect: When a unit is very busy, the nurse should rely on the UAP if the person is competent to perform the tasks. Explore the client's feelings d. Mask, 83. When determining if the client is eating a well-balanced diet 2. 2. Monitor for behavioral changes. Which of the following manifestations should the nurse identify as an indication for discontinuing the application due to a systemic response? For which of the following tasks should the nurse wear protective eye equipment. a. I will begin 48 hr before the client's discharge In what order should the nurse see the clients? Temporary urinary retention (common for clients to develop after removal), 90.
Solved A charge nurse is making client care assignments. | Chegg.com 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. The third client that should be assessed by the nurse is the client diagnosed with hemorrhoids who had some spotting of bright red blood on toilet tissue with last bowel movement. What should the nurse do first? 2. Which of the following findings should the nurse expect? D. Which of the following actions should the nurse take? Dentures should be stored in a denture cup. Taking the report from the ED could be delayed but is a courtesy to the ED and will provide information about the client that will be useful in making assignments for the next shift. d. Droplet, d. Bend at the knees when picking up an object, 98. A nurse identifies a pressure ulcer after a client had a long, extensive recovery following a surgical procedure.