Which of the following actions should the nurse take prior to administering the tube feeding? An LPN/VN has been floated to the emergency room following a chemical plant explosion. Disconnect client's nasogastric (NG) tube suction to allow ambulation. 4. 1., 2., 3., & 4. 4. Ask for any staff objections to rearranging work hours. c. Changing a dressing, 78. Check environment for potential safety hazards. Client #5 -It is considered within the scope of practice for an LPN/LVN to monitor a transfusion of a blood product. 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 a. Broth A nurse is caring for a client whose partner asks to speak with the nurse. This invasive procedure results in some edema to the vessel used for the procedure but assessing only one pedal pulse does not provide sufficient data to verify a complication. A nurse is administering a cold therapy application to a client. Based on these findings, to which of the following providers should the nurse request a referral for the client? c. Complete an incident report 5. Incorrect: This will take a lot of time and is best initiated from the "best practice" committee. The charge nurse might not have realized all the responsibilities of taking this team of clients. c. Assist the client to the floor and begin mouth-to-mouth In option #4, we see that the leading zero is missing from the prescription. c. When asking the client how he completes his ADLs This is a task that can be delegated to the LPN/LVN. d. Motor impairment, 84. Change the subject when the client behaves defiantly It is quicker to administer medications intravenously in the hospital Correct: It would be best to explore the reason the RN thinks the assignment is too heavy. A nurse is caring for a client who has had an allogenic hematopoietic stem-cell transplant. Which observation of denture care by the unlicensed assistive personnel (UAP) would require the nurse to intervene? 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. Ask the charge nurse to evaluate the intervention. A nurse instructs a female client about collecting a midstream urine sample. 1. Richied5864 Richied5864 . The client then states, "I have changed my mind and do not want to have the procedure done." Incorrect: Discharging a client includes teaching and a review of medications to be taken at home. The partner relates her concerns about her spouse abusing alcohol and having difficulty maintaining employment. Wears a gown when entering the room of a client who requires contact precautions Which of the following instructions should the nurse include? 4. Determining the client's length of stay If a sentence is already correct, write CCC. 1. Incorrect: Is phantom pain something that is unexpected with above the knee amputations? Places the soiled linen in the floor before bagging it The nurse is focusing on which of the following elements of the communication process? A nurse is admitting a client who has a partial hearing loss. A home health nurse is conducting a home safety assessment for an older adult client. one of the licensed practical nurses Get the answers you need, now! The charge nurse should be informed that the delegated intervention is not appropriate according to the state's Nurse Practice Act. Client scheduled for breast reconstruction after mastectomy. Therefore, this client needs the advanced assessment skills of the RN and should not be assigned to the LPN. However, there are some basic points which are standard among all facilities. 4. 2. The client states, "I'm feeling a bit nervous today." Correct: The LPN/LVN can monitor for behavioral changes and can look for potential safety hazards. There are a total of 10 adult clients. The client should be assessed first to rule out respiratory difficulty and hemorrhage. 3. An experienced neurological nurse should be assigned to this client to assess and manage for signs and symptoms of increasing intracranial pressure. Explain to the RN that all the nurses have the same number of clients. Assign a nursing assistant to help the client with self-care activities. b. Negligence Select all that apply. As part of an annual physical examination a nurse is preparing a client to undergo a chest x-ray. 4. Pointing to the two glasses partially filled with water, the magician asked, "Which glass contains the least water?". 3. 1. December 5, 2020. Alcohol consumption increases the use of folates, and the alcoholic diet is usually deficient in folic acid. 3. c. Can you tell me why you chose me? b. Additional data includes pulse 100/min, RR 24/min, BP 124/76 mm Hg, and temp 36.8C (98.2 F). Speak to the UAP first and then decide if a between meal supplement is needed. Teach the UAP to change surgical dressings. Following a large hurricane, multiple clients arrive at the emergency room for treatment. 1. d. I shouldn't advice you about what is ultimately a personal decision, b. 3. A nurse is caring for a client who is scheduled for an elective surgical procedure. The body needs vitamin B12 to make red blood cells. Correct: Nurses must use and recognize appropriate terminology and abbreviations to avoid potential client harm. Assist client to brush and floss teeth. 5. 4. The nurse delegated feeding of a client to the unlicensed assistive personnel (UAP). A nurse is caring for a client who is about to have a colonoscopy. d. Complete an incident report, 70. 4. Notify the nursing supervisor of the situation. Which of the following findings indicates that the client is meeting this goal? a. Feed a client that had a stroke 3 months ago. a. The assignment process requires constant evaluation and reevaluation of information and priorities. Correct: A thoracentesis is performed to remove fluid from the pleural cavity and improve the client's respiratory status. The cause of the fall may be cardiac, but the question does not indicate this. Which of the following should the nurse include as a criterion for applying restraints? A nurse is giving a presentation about client confidentiality to a group of newly licensed nurses. A nurse is teaching a client about the physical effects of chemotherapy. Assist a client to ambulate using a gait belt. The key word in the stem is first. A nurse is preparing medication for a client when another client has an emergency. Remind the client that a signed informed consent form is a legally binding document Explain administration is demanding a decreased overtime. c. Review a low-sodium diet for the client who has hypertension "Please explain what you mean by the word 'nervous'.". 1. A nurse is discharging a client who has come to the outpatient clinic with an ankle sprain. 3. 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. The client is receiving IV fluids through an IV catheter inserted in the basilic vein on the right forearm. Elderly clients have special fluid and electrolyte issues after a fall. The nurse should base her pain management interventions primarily on which of the following methods of determining intensity of the client's pain? Oral surgeon Correct: The hospital nurse to client staffing ratio should reflect the complexity of nursing care for high acuity clients. Incorrect: The nurse retains the responsibility for the delegated task. This client is stable and predictable. To focus on effective learning with this client, which of the following interventions should the nurse use? 2. Feed the client after warming the food. d. Question the charge nurses about the care deficits that might have contributed to the ulcer's development, b. Incorrect: There are situations in which the LPN must notify the primary healthcare provider. Because a scope is inserted through the urethra for this procedure, the client may experience burning or frequency immediately following this test. d. Water heater temp 54.4 C (130 F) c. Surgeon (the health care provider who will perform the treatment or procedure is responsible for obtaining informed consent from the client). c. I should purchase a carbon monoxide detector for my home Tenderness over the symphysis pubis This protein is released by cells in the stomach. Right forearm Which of the following explanations should the nurse provide? Which of the following infection-control precautions should the nurse use caring for this client? 1. a. The first client needing the nurse's attention is the one reporting a headache and has a fruity odor to their breath. Incorrect: The RN is responsible for teaching. He charge nurse is making client care assignments for the evening shift. Which of the following statements should the nurse identify as an indication that the client understands the instructions? 4. e. Time, c. The nurse may serve as a witness to informed consent for organ donation (nurses may witness the consent for organ donation after a specially trained professional requests consent), 23. Incorrect: A UAP may not remove and change surgical dressings, which would involve assessment and further education. c. Interpersonal (interpersonal communication is face-to-face interaction with another person. Which client should be assigned to the most experienced nurse? A nurse is caring for a client who states, "I have got to get out of this hospital! Which of the following actions should the nurse take? Which of the following items should the nurse offer the client? d. I decline this opportunity at this time, b. 4. Administering IV pain medication to a two day post op client. 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 Estimate the number of Calories in two tablespoons of peanut a charge nurse is making client care assignments for the day. Symbolic communication The nurse caring for the client at the time of death requests organ donation Incorrect: This client is exhibiting early signs of increased intracranial pressure. 2. CORRECT: The client is potentially experiencing symptoms of an impending seizure, which can include seeing halos around lights or detecting odd smells. This client should report an improved respiratory, not shortness of breath. In order to reorganize staffing, the nurse manager should initiate which action first? 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. A client with a fractured right humerus who reports the cast is too tight. A nurse in a long-term care facility is observing an AP changing the linen for a client who has fecal incontinence. The women's health charge nurse is making assignments for the next shift.