The nurse has been assigned four clients. The nurse should use close-ended questions when assessing which of the following factors? Electric comes from the Latin word for amber, a substance which readily takes a static electric charge. ESSENTIAL FUNCTIONS: Provide the best possible nursing care by planning, organizing, and directing the nursing functions of patients in the unit. Incorrect: The nurse is responsible for evaluating a client. The client will need to be assessed, but there is no specific indication the respiratory status is presently compromised. Because facilities generally prefer some type of consistent schedule for staffing purposes, older visitation policies were often very restrictive. Which task should the nurse take responsibility for completing? A nurse is caring for a client who is immobile. 5. 6. 3. This client would not be a priority to be seen before assessing the client with the cast that is too tight who may be developing compartment syndrome. 3. A newborn is admitted to the nursery with a diagnosis of rule out cytomegalovirus (CMV). Make referrals to community services. Vaginal delivery of fetal demise, C-section with pneumonia, 32 week gestation with lymphoma. What proposal would the nurse determine to best meet the needs of families and clients in long term care? Which of the following statements by the newly licensed nurse indicates understanding of the purpose of documentation? d. Droplet, d. Bend at the knees when picking up an object, 98. The partner relates her concerns about her spouse abusing alcohol and having difficulty maintaining employment. Select all that apply. However, it remains true pain for this client and the client would need intervention to help manage this pain. b. 5. Each ROM movement should be repeated 5 times during the session. b. A nurse is caring for a client who states, "I have got to get out of this hospital! 4. a. M4 Client Care Assignment.pdf - Making Client Care b. c. To determine the client's electrolyte balance d. Swab an area of skin away from the wound to identify the usual flora, a. Elicit info from the client (obtaining info from the client is a component of orientation phase), 57. Remove all metal necklaces "The client is weak on the right side, so please assist the client with dressing . Alcoholic Anonymous a. Therefore, this would not be the most appropriate nurse to assign to this client. 5. The best practice committee works to improve clinical practice based on current research. December 5, 2020. They are more direct when discussing issues Oral surgeon c. Washes and rinses her hands for 10 seconds, 11. d. Perception 1. Which of the following is a characteristic of men that the nurse should consider when beginning the nurse-client relationship? Which tasks should the charge nurse delegate to the nursing assistant? Incorrect: When a unit is very busy, the nurse should rely on the UAP if the person is competent to perform the tasks. The nurse should not be assigned to provide care if impairment is suspected. 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. Incorrect: A lumbar puncture involves removing cerebrospinal fluid from the subarachnoid space to diagnose specific diseases or the presence of bacteria. d. There is no blood return when the tubing is aspirated, c. I will cover the catheter so he cannot see it (using stockinette or clothing to cover the IV insertion site is an appropriate distraction technique and might steer the client's attention away from the catheter), 62. 2. Provides safe, effective delivery of patient care in . Remember, pick the killer answer first! Triage and assign color-coded tags to each client. Did the words diabetic neuropathy make you think that a LPN should not be assigned to this diabetic? A nurse is using the communication principle of presence when establishing a collaborative relationship with a client. Reporting laboratory findings to a member of the client's family A nurse is caring for a client who is scheduled for an elective surgical procedure. d. The nurse has already considered alternatives to restraints, a. Sit side-by-side with the client However, there are some basic points which are standard among all facilities. Teach the UAP to change surgical dressings. Which of the following actions indicates that the AP understands the principles of infection control? Evaluate pain relief after narcotic administration. Even though this nurse just had a baby, there is no risk of her transmitting this virus to her child. There are a total of 10 adult clients. - Assisting a client to ambulate using a gait belt. 2. Female client stating she has been raped. Removing the abdominal dressing A charge nurse is making client care assignments. 1. Discussing a client's surgical procedure with the nurse manager Disconnect client's nasogastric (NG) tube suction to allow ambulation. Transfer essential medical record to the receiving facility. This can prevent harm to client's. 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 nurse is assessing a client who is experiencing prostatic hypertrophy. This center functions as 'information central', where all plans or activities are coordinated and determined by those personnel. 3. The nurse should base her pain management interventions primarily on which of the following methods of determining intensity of the client's pain? 3. 3. 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. b. a. I'll sit with my knees lower than my hips 2) Assist a client to ambulate using a gait belt. b. I should call my doctor if I find it harder to concentrate Client assignments are based on client acuity and nurses do not necessarily have the same number of clients. The healthcare team should recognize the client as the center of the team. 4. (Select all that apply.). Review a low-sodium diet for a client who has hypertension. d. Determine if the client uses hearing aids, b. 2. a. The LPN should refuse the intervention. A nurse is creating a discharge plan. Correct: The client who has a cast and requires pain medication is a stable and predictable client. C-section planning discharge, postpartum infection, mastectomy. c. Inflate the balloon when the urine flow stops A nurse on a medical unit is caring for a client who suddenly becomes confused and drowsy. Encourage the client to be more cooperative. The reason for the UAP not feeding the client needs to be determined. Tenderness over the symphysis pubis d. Decreased calcium excretion, c. Provide the client with a diet high in protein (inadequate intake of protein, iron, vitamins, and calories increase the risk for skin breakdown), 27. Turn on local news for up-to-date information on the train derailment. 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. 4. a charge nurse is making client care assignments for the day. Two hours . The below statement corresponds to a numbered sentence in the passage. a. Semi-formed stools are great news! d. Proceed with the preparation of the patient's surgical procedure, 15. c. Changing a dressing, 78. 2. Correct: The best first action for the nurse is to identify a problem, and follow up with the appropriate person. Charge Nurse - RN | Fresenius Karriere Cardiac catheterization with a decreased pedal pulse below insertion site. a. c. The restraints should promote the client's safety and prevent injuries Respite care provides holistic support and care for a client who is terminally ill Reach around the pack and open the top flap away from the body d. Providing information, a. 5. A home health nurse is conducting a home safety assessment for an older adult client. Nothing by mouth (NPO). 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. The body needs vitamin B12 to make red blood cells. 4. A client receiving a blood transfusion that requires monitoring. 1. d. What have you done in the past to cope with this issue? Printable Nursing Brain SheetPrintable Nursing - soyu.caritaselda.es The nurse has just completed a 12 hour shift. Nurses Report Sheet Template Nicu. 3. c. I suggest you talk with a mental health counselor about your concerns d. Routine acquisition of a urine specimen 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). This client is stable and predictable. Select all that apply Well, do you see the q.d.? A family member requests that the nurse apply restraints. A nurse is talking with a client who is about to start using transcutaneous electrical nerve stimulation (TENS) to manage chronic pain. Even though this nurse just had a baby, there is no risk of her transmitting this virus to her child. 1., 2., 3., & 4. c. Tie linen bags securely at the top 4. A nurse is assessing a client at a follow-up clinic for acute low back pain. 2. The cause of the fall may be cardiac, but the question does not indicate this. Correct: Clients diagnoses with folic acid anemia typically have developed the anemia from chronic alcohol abuse. 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). Flexible hours allow clients and families to spend more quality time together, increasing positive outcomes and satisfaction. 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. b. Dons gloves to empty a urinary drainage device the nurse responds, "don't worry, no one will harm your family." Dr. Frankenstein had seen himself as a(n) ?\underline{? 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. b. 6. The nurse suggest that the family might need to respite care services. d. Reduced blood viscosity, a. Auscultating heart sounds Of the following barriers to learning the nurse identifies with this client, which should the nurse interpret as a need to postpone the session? 3. d. Motor impairment, 84. Which client should the nurse assess first? 6. Providing hygiene care to a client who is HIV positive c. They tend to use more verbal communication Which task would be appropriate for the nurse to assign to an unlicensed assistive personnel (UAP)? & 3. Which of the following tasks should the nurse delegate to unlicensed assistive personnel (UAP)? 3. Complete a client assignment sheet for the oncoming staff. A nurse is working with an AP while caring for a surgical client who is 1 day postoperative. e. Talking with the client's partner, 79. b. Summarization 3. 4. 2. Review the action of insulin therapy They are more direct when discussing issues (men focus on issues and discuss them more directly and readily than women do), 20. Correct: The nurse should recognize that this child has a very low absolute neutrophil count (ANC), which is referred to a neutropenia. A charge nurse is making client care assignments. However, providing care for missing teeth would also be within the LPN scope of practice. The nurse also needs to be aware of the color and amount of urine voided. Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. Correct: Advance directives do consist of two types of legal documents: Power of Attorney and a Living Will. Symbolic communication a. I wish I didn't have to attach the electrodes to my skin 3. c. I'll need to shave the hair off the skin where I place the electrodes During report, the nurse notes that the float nurse appears disheveled, flushed, and is trembling slightly while drinking coffee. The charge nurse must triage and assign clients to appropriate staff. 2. Which of the following findings should the nurse identify as a safety risk? Following the teaching, the nurse asks the client to describe one physical effect. Use the tablet's packaging to pick it up from the counter Assign more daily tasks to the UAP. The supervisor can only send one LPN/LVN to the floor. The nurse is using which level of communication at this time? I'm drinking plenty of fluids." 1, 3 & 5. It contains a blank and is followed by four answer choices. The nurse chooses to confront the client. Which of the following actions should the nurse take? Which clients would be appropriate assignments for the LPN/LVN? 3. The last client that should be sent back for care is the client experiencing epigastric pain and nausea after eating. Teaching about a medication Which of the following actions is an example of a violation of confidentiality? This determination is needed to assure client safety is being considered. b. Incorrect: An Advance Directive is a written, legal document regarding preferences for medical care should a person become unable to make medical decisions. A nurse is caring for a client who is postoperative. 4. One important aspect is encouraging the flow of ideas between management and staff members. c. Take the client to the bathroom every 2 hr a. d. Remove tea and coffee from meal trays, b. Write the letter of your choice on the answer line. b. I'm so sorry to hear about this Prospectors are considering searching for gold on a plot of land that contains 1.31g1.31 \mathrm{~g}1.31g of gold per bucket of soil. b. The charge nurse must assign the clients to a team consisting of RNs, LPN/LVNs, and one CNA. Incorrect: Most adults have already been exposed to the virus and are not at risk for adverse effects of the infection. c. Providing anticipatory guidance to a client in crisis Empty the drainage bag at least every 8 hrb.) Decreased RBC production In planning care for the post-operative client, the nurse has decided to retain the task of vital sign assessment. A nurse is admitting a client who has a partial hearing loss. Correct: All facilities are required to develop a disaster plan, per JCAHO (Joint Commission on Accreditation of Healthcare Organizations) regulations, though the plans vary.

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