Bath Chronicle Death Notices This Week, 420 Friendly Hotels In Oklahoma, Job Vacancy In Canada For Ethiopian, Christopher Scott Son Of Randolph Scott, Articles A

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. A nurse asks a client how he is feeling. Fruity breath. d. Assault, b. It is quicker to administer medications intravenously in the hospital Incorrect: The charge nurse cannot change the scope of practice for the LPN by evaluating the intervention. 208 1., 2., 4., & 5. The client post PEG placement is stable. 3. leadership management of care nurse on unit is providing care for group of clients. a. Nurse-patient assignments help coordinate daily unit activities, matching nurses with patients to meet unit and patient needs for a specific length of time. d. I will wear synthetic clothing and woolen socks when using my oxygen, c. Check to see if the suction equipment is working, 74. The charge nurse is making client assignments for a neuro-medical floor. Everyone knows there are others who can chair this committee better than me Incorrect: Restricting visitation to two hours is not appropriate, particularly for families traveling long distances to visit a client. Those clients who may be discharged or transferred will be informed, but it is not appropriate to alert every client. 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. Which instruction provided by the nurse reflects effective communication regarding delegation to assistive personnel? When staff do not feel vested in any new process, there is a sense of underappreciation. 1., 2., 3., & 4. This stage involves constructive efforts on the part of the group members c. The client was restless and trying to get out of the bed all evening 4. Which clients could be assigned to an LPN? a. I will keep my walker at the end of my bed The nurse received a client following surgery 8 hours ago. Which of the following actions should this nurse take? 2. Provides day to day direction and supervision to assigned direct patient care staff. butter, which contain 16 g of protein, 7 g of carbohydrates, c. Consensus evolves in this stage Select all that apply Which of the following interventions should the nurse include? The nurse could definitely be part of the committee. d. I'll carry heavy objects close to my body, d. Places clean linen that touched the floor in the soiled linen bag, 25. 5. A newly hired nurse in a long term care facility has been asked to assist with revising old policies regarding family visitation schedules. A nurse is admitting a client from a long-term care facility. Incorrect: A lumbar puncture involves removing cerebrospinal fluid from the subarachnoid space to diagnose specific diseases or the presence of bacteria. Refuse the delegated intervention. The area surrounding the insertion site feels warm to the touch, 61. Incorrect: This prescription is written correctly. This action will promote the client's self-esteem, and may reduce the quarrelsome behavior. This client needs careful monitoring and specialized care. 3. 3. The LPN can monitor the wound and provide care to the PEG insertion site. 1. d. Transporting a cerebrospinal fluid specimen to the lab 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. The charge nurse identifies that three admissions were received during the night shift, one nurse has called in sick, and the clients on the unit have high acuity levels. c. Review a low-sodium diet for the client who has hypertension c. imaginary 4. An adult (18 years or older) can create an advanced directive. The nurse is planning care for a client admitted with Alzheimer's Disease. a. The charge nurse might not have realized all the responsibilities of taking this team of clients. Because a scope is inserted through the urethra for this procedure, the client may experience burning or frequency immediately following this test. Which of the following sites should the nurse plan to use to obtain the blood specimen? d. Droplet, d. Bend at the knees when picking up an object, 98. The LPN/LVN can gather data, but the RN is responsible for validating and interpreting that data to assess and evaluate. Which of the following actions indicates that the AP understands the principles of infection control? d. Motor impairment, 84. Disconnect client's nasogastric (NG) tube suction to allow ambulation. 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. 1. A client post pacemaker insertion, awaiting discharge instructions. A nurse is caring for a client whose partner asks to speak with the nurse. Which action should the nurse interrupt the UAP from performing? If a sentence is already correct, write CCC. Of my three brothers and sisters, my sister Giselle has the best sense of humor. The second client that needs to be seen by the nurse is the client having weakness, a sign of hypoglycemia. Which of the following info should the nurse include? 4. Demonstrate the use of clinical reasoning in prioritizing and evaluating the delivery of client care. Twist at the waist when she moves an object to one side Assign a nursing assistant to help the client with self-care activities. 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. c. Depression 4. b. The UAP can assist clients with hygiene care, so it is within the scope of practice for the UAP to assist a client with a sitz bath for the postpartum client. The nurse did not trust the new UAP. A family member requests that the nurse apply restraints. Correct: The client may be experiencing a myocardial infarction and requires further assessment. Which of the following activities should the nurse perform in this zone? Teach caregivers memory enhancement aids. Yes! Teaching insulin self administration to a diabetic client. Select all that apply d. Providing information, a. Gather and apply dressings to open wounds. b. Ask the client to perform a return demonstration of insulin injection e. an open perineal wound, 92. 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). Well, do you see the q.d.? Incorrect: What seems to be going on with this client? 1. d. Fill linen bags with as much soiled linen as possible, b. Negligence (negligence is the failure to provide the expected standard of care. a. b. _________________ (magnanimous), a. generous Client diagnosed with gastroenteritis who reported 300 mL diarrhea stool x2 in the last hour. 3. 2. Feedback 1. a. a. Hypotension 2. c. The nurse may serve as a witness to informed consent for organ donation a. Bargaining a. Elicit info from the client a. This could cause a medical emergency. The charge nurse on the postpartum unit is making assignments. The nurse has been assigned four clients. Denial a. 2. 76. 1. Hold the penis at a 30 to 45 degree angle when inserting the catheter 3. b. Incorrect: Medications are not transferred with the client to a new facility. Which of the following responses should the nurse make? 2. 208 (a client who has TB requires airborne precautions; that means a private room with negative air pressure flow), 21. Also, making a surgical bed for the client returning from surgery is a basic procedure. Because the charge nurse observes and weighs . The nurse assists the patient to the bedside commode and the client sustains an injury to the operative area. A nurse is discussing indications for urinary catheterization with a newly licensed nurse. A nurse in a long-term care facility is observing an AP changing the linen for a client who has fecal incontinence. This is outside the scope of practice for the LPN/LVN. Talk to each nurse about concerns related to assigned clients. Assess personal level of fatigue prior to making a decision regarding accepting or refusing assignment. a. b. As part of an annual physical examination a nurse is preparing a client to undergo a chest x-ray. c. Take the client to the bathroom every 2 hr Vaginal delivery of fetal demise, C-section with pneumonia, 32 week gestation with lymphoma. b. 4. 4. What is the primary factor for the charge nurse to consider when delegating care? This assumption is not appropriate, and the feelings and concerns of the client should be addressed. Which clients should be assigned to the CNA? 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. (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 Did you think dehydration and fluid volume deficit? 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? The client is apparently stable and does not require any advanced assessment skills or specialized care. Which task would be appropriate for the nurse to assign to an LPN/VN? b. Dons gloves to empty a urinary drainage device b. 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. 4. 1) Bathe a client who had an amputation 2 days ago. A nurse in a clinic is teaching a group of clients about preventing low back pain and injury. Compartment syndrome could be developing which can impede circulation and cause nerve damage. Incorrect: Irrigating a client's ear canal is outside the UAP's scope of practice. 3. 4. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. This is normal for clients with hemorrhoids. Which of the following statements should the nurse identify as an indication that the client needs further teaching? They are able to manage tasks related to basic care. Well, many diabetics experience diabetic neuropathy and it is not a situation that makes this client unstable or critical. 3. Thus they are kept in charge of basic patient care like administration of tests, medicines and proper provision of the required treatment. Assist the float nurse with the clients case. c. We administer all medications intravenously to clients in this unit Incorrect: If alcohol or drug dependency is suspected, confrontation will result in hostility and denial. Incorrect: The RN is responsible for teaching. A nurse is caring for a client who has emphysema and has difficulty with mobility. 2. Select all that apply. one of the licensed practical nurses Get the answers you need, now! Therefore, the nurse with the labor and delivery experience would be more appropriate to assign to this client. b. What should the nurse do first? "Please explain what you mean by the word 'nervous'.". What proposal would the nurse determine to best meet the needs of families and clients in long term care? a. The nurse prefers to check all vital signs on all clients. Client who requires teaching about the use of a patient-controlled analgesia (PCA) pump. Accept the client's behavior as confrontational. Although this will require assessment, this client is not the priority at this time. Wears a gown when entering the room of a client who requires contact precautions Focusing c. Do not eat or drink anything the morning of the test This would be out of the UAP's scope of practice. d. Establishing the client's secondary medical diagnoses, b. A client on a surgical unit frequently quarrels with the staff. A newborn is admitted to the nursery with a diagnosis of rule out cytomegalovirus (CMV). Document current functional status assessment c. Interpersonal (interpersonal communication is face-to-face interaction with another person. Incorrect: The charge nurse does not have to assess every client. 1. 1. c. I will place an area rug at the entry of my bathroom The nurse should base her pain management interventions primarily on which of the following methods of determining intensity of the client's pain? No! 2. Incorrect: The purpose of a cystogram is to examine the inside of the bladder to confirm the presence or absence of abnormalities, or even obtain a biopsy. Based on this information,what should the nurse do? Evaluate client's safety risk factors. The cleint's family asks the nurse for info about this type of care. Client reporting a headache and has a fruity breath. Correct: Communication is important in delegation, as is follow-up. b. Irrigate the wound with an antiseptic prior to obtaining the specimen 1. Channel This is an elderly client who is a new admit. Sudden attacks of sleep This will take a lot of time, and the charge nurse can get the information needed from the nurses caring for the clients in order to make appropriate client assignments for the next shift. d. Lean back in the chair, b. The client with chronic emphysema has expected shortness of breath. The responsibility of the nurse manager is to implement change in a positive manner, while assisting staff adaptation even to unpopular modifications. d. Perception A nurse is filling out an incident report after finding a client lying on the floor. What is the best first action for the nurse to take in order to achieve this goal? Following the teaching, the nurse asks the client to describe one physical effect. When he arrives for his first dialysis treatment, he tells the nurse, "I decided to come today, but I am not sure if I will need to come back again this week. 4. Hormone replacement does not affect the immune system and, therefore, this nurse is not at risk for infection from CMV exposure. a. 10. 77. b. 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). 3. Incorrect: Obtaining the urinary output of a client at the end of the shift is appropriate for the nursing assistant and should be documented and reported to the RN. 1. a. Incorrect: Moistening the dentures will ease insertion. Incorrect: Just because the UAP is able to accomplish all daily assignments efficiently does not mean more work could be handled as effectively. & 3. Assigning blame for the changes to administration will not help staff adjust. Inform the client of the need to avoid irritants such as carbonated beverages. Which of the following responses should the nurse provide? 3. 2. Relief of urinary retention A nurse is caring for a client who states, "I have got to get out of this hospital! A nurse is teaching a client who has a history of falls about home safety. 2. Which of the following instructions should the nurse give to the client prior to the procedure? (SATA) -Bathing a client who had an amputation 2 days ago. Places the soiled linen in the floor before bagging it 3. The first vital sign check was performed by the nurse. Client diagnosed with hemorrhoids who had some spotting of bright red blood on toilet tissue with last bowel movement. 3. PURPOSE AND SCOPE: Supports FMCNA's mission,vision, core values and customer service philosophy. The charge nurse is planning the staff assignments for the clients on a neurological unit. c. I will make sure my visitors smoke outside A charge nurse is making assignments for an oncoming shift. Which of the following actions is an example of a violation of confidentiality? 3. a. There is a possibility that a hypothermia blanket may be prescribed. 1. a. This client is likely in metabolic acidosis due to diabetic ketoacidosis (DKA). d. Otorhinolaryngologist, c. Irrigating a client's abdominal wound Correct: A long term care facility is considered a client's "home environment", and families are encouraged to visit often. d. Clients are placed on artificial life support before organ and tissue donation can occur, a. I'll sit with my knees lower than my hips (client should sit with knees slightly higher than their hips to prevent injury), 24. Incorrect: The nurse is responsible for evaluating a client. a. Lisinopril 20.0 mg PO daily 2. Based on these findings, to which of the following providers should the nurse request a referral for the client? a. c. Raised toilet seats 1. Teaching insulin self administration cannot be delegated to the LPN. & 6. c. Check to see if the suction equipment is working It contains a blank and is followed by four answer choices. The charge nurse should notify the nursing supervisor who will seek additional staff. Thoracentesis reporting shortness of breath. Which task is appropriate for the nurse to delegate to the experienced nursing assistant? 1. Correct: The unlicensed nursing assistant should not turn tube feedings off or on. A nurse is teaching a client about the physical effects of chemotherapy. Flexible hours allow clients and families to spend more quality time together, increasing positive outcomes and satisfaction. 2. These areas require the expertise of an RN and would not be appropriate for an LPN/LVN. Lumbar puncture reporting a headache. A nurse is preparing a client's evening dose of risperidone when the tablet falls on the countertop. However, it is on the "Do Not Use" list of abbreviations because it can be confused with morphine sulfate (MSO4). 1., 4., & 5. A cardiac step down unit has requested float staff because of multiple impending admissions. A nurse is caring for a client who is scheduled for an elective surgical procedure. c. Blood-tinged urine What information should the nurse include? a. Because facilities generally prefer some type of consistent schedule for staffing purposes, older visitation policies were often very restrictive. The nurse should do this when repositioning is needed. Feed a client that had a stroke 3 months ago. b. 212 1. a. I will begin 48 hr before the client's discharge 1. Incorrect: A client who has a spinal cord injury and is in rehabilitation is still alert and able to make decisions. 4. Where on the body is each type of skin found? c. Measurement of residual urine after urination A nurse is orienting a newly licensed nurse about documentation of a client's information in the electronic health record. 3. Which of the following actions should the nurse take when obtaining a wound-drainage specimen for culture? The client's self-report of pain severity Initiative vs guilt 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. Find a mentor Most nurses learn to make nurse-patient assign-ments from a colleague. Incorrect: Most adults have already been exposed to the virus and are not at risk for adverse effects of the infection. Incorrect: Passive ROM is performed with paralysis and can be delegated to the UAP. Client diagnosed with Guillain-Barre' who is receiving ventilator support. A nurse is caring for a client who receives intermittent enteral feedings through an NG tube. You get this vitamin from eating foods such as meat, poultry, shellfish, eggs, and dairy products. Which of the following actions should the nurse take? In what order should the nurse see the clients? a. Bathtub with rails a. a. Irrigate a client's ear canal. A charge nurse is planning client activities for the day. Document what the nurse believes was the cause of the ulcer development 2. INCORRECT: Although the vascular status of the foot will need to be assessed, there is no indication if the debridement has been completed yet. Complete a neurological check (appropriate nursing intervention when a client displays sudden confusion). Correct: Did you notice the hint? Encourage the client to use self-exploration Perform catheterization when you recognize the urge to void Which of the following statements should the nurse make? Complete blockage of the large intestine. 1. A. Transporting a client who experienced a stroke 72 hr ago to the radiology department A nurse in a long-term care facility is caring for an older client who has dementia and begins to have frequent episodes of urinary incontinence. Incorrect: A colostomy client with diarrhea will have a lot of drainage requiring frequent emptying of the colostomy bag. b. An adolescent client post appendectomy reporting pain. a. Clarification d. Explain oral hygiene to a client receiving chemo Incorrect: It is important to hear what the nurse is saying and not to dismiss the request by refusing to reassign the clients. 4. 1. Two nurses lifting the client under the shoulders b. 4. 3. Nurses dependent on drugs or alcohol can harm clients. When the licensed person cannot determine this, the task should not be delegated. 1. An Advance Directive includes a Living Will and a Medical Power of Attorney. a. A nurse instructs a female client about collecting a midstream urine sample. Incorrect: Here, you have a client who needs teaching about intravenous pain management using a patient-controlled analgesia (PCA) pump. Incorrect: Most adults have already been exposed to the virus and are not at risk for adverse effects of the infection. 1. a. Auscultate breath should at least ever 2 hr During lunch, Robin jotted a letter to Amy and signed it, "your friend, Robin.". What action should the nurse take after mistakenly administering the wrong medication? 4. Reporting laboratory findings to a member of the client's family (the only people allowed to receive info are those that the client has given permission and those that are working with the client and their case), 29. c. Hand-off technique So, this client who is receiving PRN pain medication is certainly someone that the LPN could be assigned to. Which of the following actions should the nurse take? c. Washes and rinses her hands for 10 seconds, 11. In option #4, we see that the leading zero is missing from the prescription. d. I'll put a heating pad on my ankle at bedtime tonight, d. I have a set of my brothers' crutches in the basement I can also use (the client should not use crutches that belong to someone else; the crutches must fit body dimensions), 17. Which client should the nurse see first? Discuss the competency of the surgeon 3. The nursing supervisor may be able to assist with client care until another nurse can come in to work. Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. The client would develop severe cramping. 5. Which of the following findings should the nurse identify as a safety risk? 2. 4. Incorrect: The nurse is assuming that the client's quarrelsome behavior is normal for this client. 3. c. Include intact skin at the wound edges in the culture Which of the following client statements should indicate to the nurse the need for additional teaching? b. Incorrect: The RN is responsible for assessment and evaluation. Refuse the overtime assignment, being prepared for disciplinary action. Provide a between meal supplement to the client. A nurse is having difficulty caring for a client due to variables affecting the communication process. Take several shallow breaths during the procedure 4. The best practice committee works to improve clinical practice based on current research. Incorrect: The RN is responsible for collecting data. However, providing care for missing teeth would also be within the LPN scope of practice. The other options may be correct but are not the best first action. Something new could have occurred with the clients, making the assignments too heavy. This documentation should go to your manager. The expected standard of care was strict bed rest), 96. There are potential problems in Options #1, 2, 3, and 4 and should be questioned and corrected. The last client that should be sent back for care is the client experiencing epigastric pain and nausea after eating. Provides safe, effective delivery of patient care in . Which of the following instructions should the nurse include? d. The presence of a bed alarm could have prevented the client from falling, b. Assess the client (to check if there is any harm to the client), 69. 4. 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. Even though this nurse just had a baby, there is no risk of her transmitting this virus to her child. The client says, "go away, no one can help me." 4. Which group of clients should she assign to the medical surgical nurse? If the client is unstable, the nurse would retain the role of measuring the vital signs. 4. 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. CORRECT: The client is potentially experiencing symptoms of an impending seizure, which can include seeing halos around lights or detecting odd smells. What is the best care assignment for this client? 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 client would be most appropriate to assign a licensed practical nurse (lpn)? The second client that should be given a treatment room is the elderly client who fell and fractured the left femoral neck. Which of the following statements should the nurse make? Include any relevant statements the client made about the ulcer b. Besides, a charge nurse is a leader on the floor and should possess . EXAMPLE: Of my three brothers and sisters, my sister Giselle has the better sense of humor. - Assisting a client to ambulate using a gait belt. The nurse should perform which of the following activities in this space? The client asks the nurse, "Why do I need that? Incorrect: This is a nursing responsibility and the best practice committee is the best place to begin. 3. d. Counting radial pulse, 100. c. Foot ESSENTIAL FUNCTIONS: Provide the best possible nursing care by planning, organizing, and directing the nursing functions of patients in the unit. The charge nurse tells a nurse that multiple sick calls from the upcoming shift has occurred. Correct: The UAP can remind the client to do something that has already been taught by the nurse. The nurse voices his concern to the charge nurse. Have a pen and paper handy d. Wait to discuss the behavior in the presence of others, a. Warm the feeding solution to the body temperature However, since the new UAP's competency level is not known, the nurse does not delegate this task for the safety of the client. The below statement corresponds to a numbered sentence in the passage. Remember, pick the killer answer first! A client who is disoriented and awaiting transfer to a long-term care facility. b. Select all that apply One nurse lifting as the client pushes with his feet 3. Everything will be okay 1. 1-month-old infant with bronchiolitis with a respiratory rate of 60 6-month-old infant with pneumonia on oxygen 4-year-old child with nephrotic syndrome with 4 protein in the urine 6-year-old child 2-day post-op appendectomy with a surgical drain 2. 2. Aplastic Anemia Support Group. The UAP can ambulate the client and can report to the nurse if the client states that pain is occurring but cannot monitor or collect data. which of the following actions should the nurse perform? A nurse is preparing to obtain a blood specimen from a client by venipuncture. Correct: The LPN/LVN can monitor for behavioral changes and can look for potential safety hazards. Encourage the client to be more cooperative. Client #5 -It is considered within the scope of practice for an LPN/LVN to monitor a transfusion of a blood product. 4. d. Use soap and water to wash the catheter after each use, c. Consensus evolves in this stage (consensus occurs and cooperation develops during the norming stage), 34. 3. d. When asking if the client took his medications this morning, 82. It would not be appropriate to overload this new employee with extra work. The nurse is reviewing some clients' prescriptions. A nurse is working with an AP while caring for a surgical client who is 1 day postoperative. d. Have the client practice blood-glucose monitoring using a glucometer, d. When asking if the client took his medications this morning, 81. Incorrect: This client is post cardiac catheterization and remains on bedrest; therefore, the affected leg must be kept straight to prevent femoral hemorrhaging. Diltiazem is a calcium channel blocker that has been ordered as a titrated drip to slow heart rate and restore a regular rhythm. Narrative interaction Correct: The best first action for the nurse is to identify a problem, and follow up with the appropriate person. Witness the client's signature (verify that the client is consenting to voluntarily and appears to be competent to do so), 71. 2) Assist a client to ambulate using a gait belt. Remove all metal necklaces Select all that apply. Gather supplies to prepare room for isolation. Which region of the tRNA pairs with mRNA? Aplastic anemia is a rare but serious condition. Turning off continuous tube feeding to reposition a client, then turning the feeding back on. Use double bagging to remove soiled linen from the client's room