a charge nurse is making client care assignmentswhat is the boiling point of acetone and water

d. I decline this opportunity at this time, b. This action is a defensive intervention, and does not address the quarrelsome behavior. Client diagnosed with Crohn's disease who had three semi-formed stools over the past shift. Client who is a diabetic experiencing diabetic neuropathy. Respite care allows the primary caregiver time away from day-to-day care responsibilities, 75. Incorrect: The RN is responsible for developing the plan of care which would include necessary referrals. During lunch, Robin jotted a letter to Amy and signed it, "your friend, Robin.". Write the letter of your choice on the answer line. c. I will cover the catheter so he cannot see it b. A nurse is preparing to move a client who is only partially able to assist up in a bed. c. Use intermittent eye contact The client states, "I am so nervous about what the doctor might find during the test." Which of the following tasks should the nurse plan to delegate to assistive personnel (AP)? d. Complete an incident report, 70. The nurse received a client following surgery 8 hours ago. d. Routine acquisition of a urine specimen Correct: It would be best to explore the reason the RN thinks the assignment is too heavy. The nurse has another priority. 4. d. Question the charge nurses about the care deficits that might have contributed to the ulcer's development, b. One nurse lifting as the client pushes with his feet 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. When assigning nurses to patients, the charge nurse must consider the acuity of the patient's condition, the skills of the nurse, and the availability of other staff members. Correct: A thoracentesis is performed to remove fluid from the pleural cavity and improve the client's respiratory status. 3. Reporting laboratory findings to a member of the client's family d. Droplet, d. Bend at the knees when picking up an object, 98. b. 3. c. Hallucinations at the onset of sleep, 65. Assist a client to ambulate using a gait belt c. Consensus evolves in this stage Vital sign measurement Incorrect: A client scheduled for surgery after a mastectomy is still able to make decisions. d. Anger, b. A nurse who is 10 weeks pregnant. d. Discard the prepared medications and begin again after returning, d. I will wear synthetic clothing and woolen socks when using my oxygen (woolen and synthetic materials can generate static electricity and oxygen is a flammable gas - the client should wear cotton), 73. Correct: The hospital nurse to client staffing ratio should reflect the complexity of nursing care for high acuity clients. A medical-surgical LPN has been sent to a short-staffed pediatric unit. Which of the following explanations should the nurse provide? 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. c. Contact Which of the following statements should the nurse identify as an indication that the client requires further clarification? Did you think dehydration and fluid volume deficit? This is on the "Do Not Use" list of abbreviations because the period after the "Q" can be mistaken for "I", which would be interpreted as qid (four times a day) instead of the intended once daily dosage. The nurse is evaluating care provided by an unlicensed assistive personnel (UAP). a. 4. 1. Which action should the nurse interrupt the UAP from performing? Which of the following info should the nurse include? Which of the following actions should the nurse take prior to administering the tube feeding? d. When asking if the client took his medications this morning, 82. *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. This is likely cholelithiasis, which will need to be checked out. Incorrect: Although this nurse may be accustomed to caring for clients in acute situations requiring a higher level of care, this nurse is not familiar with caring for clients with preeclampsia. b. Nothing will get passed the complete blockage. one of the licensed practical nurses Get the answers you need, now! Complete a neurological check (appropriate nursing intervention when a client displays sudden confusion). Dentures should be stored in a denture cup. Incorrect: The scope of practice for the UAP encompasses basic personal care needs, ambulating, and taking vitals; however, the nurse must still verify that all tasks are accomplished in a safe manner. a. What interventions can the nurse delegate to the LPN/VN? Change the subject when the client behaves defiantly It involves people who are constantly changing-their conditions improve and deteriorate, they're admitted and discharged, and their nursing needs can change in an instant. 2. Correct. a. 3. Client two days post percutaneous endoscopic gastrostomy (PEG) placement. Witness the client's signature Which client should the nurse assess first? b. In planning care for the post-operative client, the nurse has decided to retain the task of vital sign assessment. Which clients could be assigned to an LPN? & 3. A client on a surgical unit frequently quarrels with the staff. The body needs vitamin B12 to make red blood cells. Notify the primary healthcare provider of transfer completion. 3. 5. 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? Select all that apply. Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. Airborne 4. d. What have you done in the past to cope with this issue? 2. A client receives a wrong medication. (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 Incorrect: A client diagnosed with Guillain-Barre' is mentally competent and being on a ventilator does not indicate that the client has lost decision-making capacity. 3. d. I'll carry heavy objects close to my body, d. Places clean linen that touched the floor in the soiled linen bag, 25. Checking capillary refill beneath the client's fingernail The supervisor can only send one LPN/LVN to the floor. A Medical Power of Attorney is a type of Advance Directive that appoints a health care agent to make decisions on the client's behalf when the client is unable to do so. The nurse is planning care for a client admitted with Alzheimer's Disease. Incorrect: Most adults have already been exposed to the virus and are not at risk for adverse effects of the infection. Place the pack on a sterile work surface b. Correct: If suspicious behavior occurs, it is important to keep careful, objective records. A client requesting assistance packing his belongings for discharge later today., Education c. Providing anticipatory guidance to a client in crisis 1. 3. The client faces the direction of movement when sliding an object across the floor (sliding an object across the floor rather than lifting it prevents strain on the lower back muscles and facing the direction prevents from twisting his back). A nurse is working with an AP while caring for a surgical client who is 1 day postoperative. Have another nurse guard the medication preparations until the nurse returns d. Explain the procedure to the client if they do not understand, c. Lock the medication in a room and finish preparing it after returning from the emergency (securing them and returning later to finishing preparing and administering them decreases the risk of medication errors), 72. What is the appropriate assignment? If you are new to this challenge, try these eight tips as a guide for making nurse-patient assignments. Incorrect: Pernicious anemia is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12. c. I suggest you talk with a mental health counselor about your concerns b. Injuries from a motor-vehicle accident can be life threatening. Changing the subject 1. c. Distended bladder A written report of the incident is completed by the nurse and turned into the appropriate person (generally the performance improvement department). 3. d. Services are centered in long-term care facilities, a. A nurse is caring for a client who has had an allogenic hematopoietic stem-cell transplant. Ambulating a client who is 2 days post vaginal hysterectomy Those residing in long term care facilities benefit greatly from time spent with family or even older friends. Allowing staff to vent is acceptable but the nurse manager should focus on constructive methods of adjustment to the impending mandated changes. Incorrect: The nurse may trust the UAP; however, the nurse has not been able to determine the competency of the new staff member. 3. Incorrect: This is not completely practical for everyone. a. Draining the colostomy bag on a client with diarrhea. Report of feeling pressure The LPN can monitor the wound and provide care to the PEG insertion site. a. 2. c. Review a low-sodium diet for the client who has hypertension Assign more daily tasks to the UAP. 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. Client prescribed antibiotics for cystitis. The first client who needs treatment is the one with multiple injuries from a motor vehicle accident. Which of the following findings associated with urinary retention should the nurse expect? c. Decreased sodium excretion Discussing a client's surgical procedure with the nurse manager 55. A nurse is caring for a client who is about to have a colonoscopy. Point out inconsistences in the client's behavior b. 1., 2., 3., & 4. (Select all that apply.) Incorrect: Gloves should be worn to remove dentures and a gauze used to grasp the dentures. A float nurse arrives on the unit to assist in the care of clients for the shift. They are able to manage tasks related to basic care. A nurse is caring for a client who is scheduled for an elective surgical procedure. Draining of the bag is a routine toileting procedure for the colostomy client and.is within the scope of practice for the UAP. Client with an oral temperature of 103.2 F (39.5 C) 36 hours post intracranial surgery. 3. The fourth client the nurse should assess is the client diagnosed with Crohn's disease who had three semi-formed stools over the past shift. A nurse is rehearsing assertive communication approaches to use when declining leadership of a nursing department committee. Alcohol consumption increases the use of folates, and the alcoholic diet is usually deficient in folic acid. The nurse is using which of the following therapeutic communication techniques? 1. c. When asking the client how he completes his ADLs December 5, 2020. Confrontation should occur in the presence of a charge nurse or supervisor. 3. c. I will make sure my visitors smoke outside 2. 2. Correct: Disconnecting NG tube suction is an appropriate task for the UAP. c. Leave a nightlight on in the client's room Which of the following interventions should the nurse use to help maintain the integrity of the client's skin? a. Anyone over age 18 can have an Advanced directive. Which instruction provided by the nurse reflects effective communication regarding delegation to assistive personnel? e. Feed a client who had a stroke 3 months ago, 31. b. Which of the following statements should the nurse identify as an indication that the client needs further instruction? The charge nurse must triage and assign clients to appropriate staff. Monitor client for pain while assisting with ambulation. c. Request a tray without pork b. I will keep the fluorescent ceiling light on in my room at night Room 208 is a private, negative pressure airflow room; room 212 is a semi private, positive airflow pressure room; 214 is a negative pressure room, a semi private room; and room 216 is a private positive-pressure airflow room. 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. Changing a colostomy bag. b. b. b. 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). The client's self-report of pain severity Client who has multiple injuries from a motor vehicle accident. Client admitted 24 hours ago with a diagnosis of a stroke, who is now reporting a headache that intensifies when moving in the bed. The client will need to be assessed, but there is no specific indication the respiratory status is presently compromised. 3. This situation needs advanced monitoring and care, so this nurse with very little postpartum experience would not be the most appropriate to assign to this client. 2. _____The house that we lived in for nine years has been sold. d. Proceed with the preparation of the patient's surgical procedure, 15. This stage involves constructive efforts on the part of the group members Correct: An LPN should be assigned clients with predictable outcomes. Teach the UAP to change surgical dressings. c. Blood-tinged urine b. A charge nurse is observing a group of newly licensed nurses. If a sentence is already correct, write CCC. c. I will complete the smoking cessation program I started A nurse is orienting a newly licensed nurse about documentation of a client's information in the electronic health record. A 10 year old school-age child would also be more cooperative, making it easier for the LPN to interact with that client. Sit side-by-side with the client c. Gender This documentation should go to your manager. A nurse is preparing an education presentation about organ donation for a group of newly licensed nurses. 4. a. I will begin 48 hr before the client's discharge c. Assist the client to the floor and begin mouth-to-mouth 1. 5. Which task would be appropriate for the nurse to assign to an unlicensed assistive personnel (UAP)? Speak to the UAP to determine what happened with the feeding. b. Summarization The second client the nurse needs to see is the client diagnosed with gastroenteritis who had two 300 mL diarrhea stools in one hour. c. Depression 3. Incorrect: The charge nurse does not have to assess every client. M2.4 Making Client Care Assignments - GECC As the RN charge nurse, you are preparing to make assignments for the oncoming shift on the medical-surgical unit. Give magnesium citrate 296 mL at 3 PM today. c. Open the right flap with the left hand Following the teaching, the nurse asks the client to describe one physical effect. 3. Monitor for GI upset 30 minutes after meals. c. Notifying the provider of physical exam findings This is an appropriate prescription. b. Could you try contacting a support group 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. d. Determine if the client uses hearing aids, b. d. They disclose more personal information, a. 1. d. I shouldn't advice you about what is ultimately a personal decision, b. This client could be transferred with traction still maintained. (Select all that apply.). Increased insulin production On an ongoing basis, the charge nurse evaluates individual and collective outcomes of the patient care provided during their shift, compares patient care delivery to accepted standards, adjusts assignment of resources as necessary, and reports changing needs and outcomes to the health care staff. 3. 2. Obtain a urine specimen from a client with an indwelling Foley catheter. 5. What was the hint? 1. Teaching insulin self administration to a diabetic client. A client with an above the knee amputation reporting phantom pain. It is quicker to administer medications intravenously in the hospital What is the major histological difference between thick and thin skin? Assist the float nurse with the clients case. In which situation should the nurse consult the client's advanced directive? These irregularly shaped cells can get stuck in small blood vessels, which can slow or block blood flow and oxygen to parts of the body. 3. 7. a. 3. The nursing supervisor may be able to assist with client care until another nurse can come in to work. Incorrect: Discussing the assignment with another LPN is delaying the client's needed intervention. Which pediatric client care assignment is most appropriate for the charge nurse to delegate to the LPN/LVN? a. Incorrect: This client is exhibiting early signs of increased intracranial pressure.

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