An adolescent client post appendectomy reporting pain. Which of the following statements should the nurse identify as an indication that the client needs further instruction? Plan all care to be completed in early morning to allow afternoon for visitation. c. Inflate the balloon when the urine flow stops 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. 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. Battery Notify the board of nursing (BON) that the float nurse is an alcoholic. Select all that apply Left upper forearm LPNs can provide the client with needed analgesics or may simply guide the client with diversional activities for managing this type pain. Ambulating a client who is 2 days post vaginal hysterectomy Temporary urinary retention 1. A nurse just back from maternity leave. A nurse asks a client to share personal stories. 1. Document current functional status assessment The nurse is using which of the following therapeutic communication techniques? 2. 2. Explain oral hygiene to a client receiving chemotherapy Incorrect: Since this client has an obstruction, anything the client eats will not be able to come out. 6. However, it is on the "Do Not Use" list of abbreviations because it can be confused with morphine sulfate (MSO4). Client reporting epigastric pain and nausea after eating. 2. When a family member asks how respite care can help, which of the following responses should the nurse provide? a. Bathtub with rails The nurse can accept the assignment, documenting your personal concerns regarding working conditions in which management decides the legitimacy of employee's personal concerns. A nurse is prioritizing care for two clients at the start of the shift. a. Correct: The medical nurse can be assigned to this client. A nurse is preparing a client's evening dose of risperidone when the tablet falls on the countertop. Incorrect: The nurse is responsible for monitoring a client. 6. butter, which contain 16 g of protein, 7 g of carbohydrates, A newly licensed nurse is seeking advice from her preceptor about the need to purchase personal professional liability insurance. 4. 1. Notify the primary healthcare provider of transfer completion. Correct: The nurse should recognize that this child has a very low absolute neutrophil count (ANC), which is referred to a neutropenia. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. b. I will keep the fluorescent ceiling light on in my room at night a. Hold the penis at a 30 to 45 degree angle when inserting the catheter Nothing life threatening. An increased temperature will have a direct effect on the brain's metabolism and function. c. Hallucinations at the onset of sleep I'm drinking plenty of fluids." b. Incorrect: An experienced neurological nurse should be assigned to this client due to the possibility that damage to the hypothalamus which controls body temperature has occurred. Incorrect: Emergency room nurses deal with life threatening emergencies but are not specialized in the care of clients with preeclampsia. Schedule visiting times in two-hour increments so clients are not overwhelmed. 3. The nurse is focusing on which of the following elements of the communication process? a. b. I will bear the weight of my body on my hands 4. 3. Tenderness over the symphysis pubis b. Verbalize understanding of how the client feels a charge nurse is making client care assignments for the day. b. Currently, your census is 11, with one empty bed. A nurse is teaching a client about carbon monoxide poisoning. A nurse is caring for a client in the orientation phase of the nurse-client relationship. PURPOSE AND SCOPE: Supports FMCNA's mission,vision, core values and customer service philosophy. Anyone over age 18 can have an Advanced directive. Correct: An LPN should be assigned clients with predictable outcomes. A client with fibromyalgia reporting generalized pain of 7 out of 10. The nurse is working with a new unlicensed assistive personnel (UAP) on a post-operative unit. (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 When handling any disaster, a facility must have a "command center" that is operated by outside personnel such as a Fire chief, Police, Swat or other outside emergency persons. Based on this information,what should the nurse do? a. The RN with 2 weeks' experience on the postpartum unit. e. Throw rugs, 40. 2. This protein is released by cells in the stomach. Client prescribed antibiotics for cystitis. 5. 1., 2., 3., & 4. Feedback 1. a. I will wear gloves when removing food from the freezer b. 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. These individuals are selected by the charge nurse, and do not have to be nurses. 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. 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. A nurse in a clinic is teaching a group of clients about preventing low back pain and injury. d. Bend at the knees when picking up an object, 99. Which of the following nontherapeutic communication techniques is the nurse using? Which of the following activities should the nurse perform in this zone? 6. The client would develop severe cramping. b. c. Inform the surgical team to cancel the client's surgery 2. b. Donation costs are the responsibility of the donor's family and estate a. d. Message, 67. 4. Reach around the pack and open the top flap away from the body d. Places clean linen that touched the floor in the soiled linen bag, d. Decreased calcium excretion (prolonged immobility leads to the breakdown of bone tissue; result is decreased calcium excretion), 26. b. I will call the doctor and get the prescription Which of the following findings should the nurse expect? A nurse is providing discharge teaching for a client who requires home oxygen therapy. A nurse is planning home care for a 9-year-old child following an acute exacerbation of asthma. c. Review a low-sodium diet for the client who has hypertension Which clients should the nurse assign to the LPN/LVN based on skill level and scope of practice? 2. Delegate 2 nurses to work with the client. Where on the body is each type of skin found? 2. The nurse is caring for four clients. Incorrect: Medications are not transferred with the client to a new facility. Check environment for potential safety hazards. b. Which of the following types of torts has the nurse committed? A nurse is giving a presentation about client confidentiality to a group of newly licensed nurses. b. 4. Assigning this nurse to the newborn with CMV would put her unborn baby at high risk for life-long defects and even death. b. Wash the area of the puncture thoroughly with soap and water Incorrect: This client does not have a predictable outcome. b. I will come back later and we can talk 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. Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. 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. A. c. Document in the client's medical record that she completed an incident report Although this will require assessment, this client is not the priority at this time. d. Respite care is a continuation of psychological support after a family member dies. What client should the nurse assess first? A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. An LPN/VN has been floated to the emergency room following a chemical plant explosion. However, since the new UAP's competency level is not known, the nurse does not delegate this task for the safety of the client. Encourage clients and families to develop mutually appropriate visitation times. 4. 2. Removing the client's dentures 1. Removing the abdominal dressing b. Wash the tablet off with alcohol and place it in a clean medicine cup d. Transporting a cerebrospinal fluid specimen to the lab Call the client's provider 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. You get this vitamin from eating foods such as meat, poultry, shellfish, eggs, and dairy products. 2. Encourage client to express grief related to loss of independence. The nurse should use close-ended questions when assessing which of the following factors? Client diagnosed with a hemorrhagic stroke 1 week ago, who currently has a blood pressure of 170/96. Moistening the dentures prior to inserting them C. Review a low-sodium diet for a client who has hypertension. A distance of 5.00 cm is measured between two adjacent nodes of a standing wave on a 20.0-cm-long string. Which of the following actions should the nurse take prior to administering the tube feeding? Demonstrate principles of collaborative practice within the nursing and healthcare teams fostering mutual respect and shared decision-making to achieve stated outcomes of care. d. Establishing the client's secondary medical diagnoses, b. 1. 9. c. Depression c. I'll wear low heeled shoes from now on A goal for this client is to use proper body mechanics at all times. The nurse manager on a medical-surgical unit receives official notification that staff overtime must be decreased as a cost-saving measure. (Select all that apply.) After the provider determines no medical cause for the client's incontinence, which of the following interventions should the nurse initiate to manage this behavior? a. "Please explain what you mean by the word 'nervous'.". A client is scheduled for a colonoscopy with biopsy of a large tumor that is completely blocking the large intestine in the morning. The nurse delegated feeding of a client to the unlicensed assistive personnel (UAP). b. 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. A nurse in a clinic is caring for a client who reports pain, crepitus, and a popping sound is his temporomandibular joint. B. A nurse is adhering to standard precautions while caring for a group of clients. This is outside the scope of practice for the LPN/LVN. A nurse is admitting a client who has a partial hearing loss. The charge nurse delegates a licensed practical nurse (LPN) to perform an intervention that is not within the scope of practice for the LPN. Monitor for behavioral changes. Each ROM movement should be repeated 5 times during the session. Which of the following sites should the nurse plan to use to obtain the blood specimen? c. We administer all medications intravenously to clients in this unit Which of the following actions should the nurse take to assist the client with feeding? a. c. 214 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. Initiate oxygen and IV lines as needed. A charge nurse is making client care assignments. The charge nurse asks the nurse who works in a state where mandatory overtime is legal to work an additional 8 hours of mandatory overtime. b. Emptying a urinary drainage bag for a client who has pneumonia 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. a. Shakes the soiled linen to remove any toilet paper remnants 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. This documentation should go to your manager. 208 Increased insulin production So, the UAP can assist a client to brush and floss teeth. Warm the feeding solution to the body temperature Which of the following responses should the nurse provide? Client with chronic emphysema experiencing mild shortness of breath. 3. This determination is needed to assure client safety is being considered. a. Transpersonal b. Intrapersonal c. Interpersonal d. Public b. a.) In which harmonic number n is the string vibrating? A client receives a wrong medication. An experienced neurological nurse should be assigned to this client to assess and manage for signs and symptoms of increasing intracranial pressure. 1. The charge nurse's best response is to first obtain the needed information to make the best decision. 2. 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. b. Pain 3. c. Behaving defensively Client assignments are based on client acuity and nurses do not necessarily have the same number of clients. Incorrect: This prescription is written correctly. 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. The client with chronic emphysema has expected shortness of breath. Keep the drainage bag at the level of the bladder c.) Use the clean technique to collect a specimen from the drainage system d.) The client must understand the need for restraints The first client who needs treatment is the one with multiple injuries from a motor vehicle accident. A nurse is caring for a client who is postoperative.
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