Changing the subject What task would be best to assign to the LPN/LVN? Incorrect: The concern here is the client being fed their meal. A list of current medications is sent to the facility. Notify the charge nurse of the observations. a. Broth A nurse is caring for a client who states, "I have got to get out of this hospital! Places the soiled linen in the floor before bagging it Alcohol consumption increases the use of folates, and the alcoholic diet is usually deficient in folic acid. 2. Occupational therapist Which of the following actions is the nurse's priority? To focus on effective learning with this client, which of the following interventions should the nurse use? Which of the following statements should the nurse identify as an indication that the client needs further instruction? 1. Which of the following interventions should the nurse use to help maintain the integrity of the client's skin? Incorrect: Although this nurse is working on the postpartum unit, did you recognize the length of experience? This is a task that can be delegated to the LPN/LVN. Correct: The nurse's level of fatigue must be considered especially under conditions of mandatory overtime. Phone report to the receiving nurse. The spouse can rescind the Advance Directive if the client becomes unresponsive. Licenced practical nurses are a little less educated than registered nurses. Delegate 2 nurses to work with the client. The surgeon initially prescribes a clear liquid diet. The LPN can monitor the wound and provide care to the PEG insertion site. Dexlansoprazole 30 mg PO daily. b. However, providing care for missing teeth would also be within the LPN scope of practice. b. 6. 1., 3, & 4. Documentation is a communication tool for the interprofessional health care team. It can result in muscle spasm and tissue damage. Plan all care to be completed in early morning to allow afternoon for visitation. A nurse is caring for a client whose partner asks to speak with the nurse. c. Contact The area surrounding the insertion site feels warm to the touch Which client should the nurse see first? Incorrect: This will take a lot of time and is best initiated from the "best practice" committee. b. 212 Elderly client admitted 30 minutes ago with reports of constipation for four days. Making client care assignments As the RN charge | Chegg.com Science Nursing Nursing questions and answers Making client care assignments As the RN charge nurse, you are preparing to make assignments for the oncoming shift in the medical-surgical unit. This is outside the scope of practice for the LPN/LVN. d. Your provider has prescribed antibiotic therapy to be administered intravenously every 6 hours, 95. Client diagnosed with a hemorrhagic stroke 1 week ago, who currently has a blood pressure of 170/96. c. Contact the provider to question the dosage (when a nurse believes there is an error in a prescription, the nurse must question the provider). Teaching insulin self administration cannot be delegated to the LPN. Which of the following statements by the nurse would provide UAP with the best directions about an assignment? a. Correct: The UAP can remind the client to do something that has already been taught by the nurse. a. Following a passenger train derailment, local hospitals are notified to activate disaster protocols on all floors. Witness the client's signature c. Notifying the provider of physical exam findings 4. The word or phrase that you choose must express roughly the same meaning as the italicized word in the passage. Where on the body is each type of skin found? 3. b. Clients are frequently admitted to a medical unit with a diagnosis of seizures and prescribed an anti seizure medication. 1. INCORRECT 3) Review a low-sodium diet for a client who has hypertension. 2. a. I'll apply ankle to my ankle today and tomorrow Well, many diabetics experience diabetic neuropathy and it is not a situation that makes this client unstable or critical. Read all the current literature related to oral care on unresponsive clients. leadership management of care nurse on unit is providing care for group of clients. 5. Client eating a simple-carb snack due to weakness. 3. c. Industry vs inferiority 3. This could be devastating to the client if the decimal point is missed and the client receives 200 mg instead of the intended 20 mg of lisinopril. The RN with 5 years' experience in the Labor and Delivery unit. 1. A nurse is assessing a client who has narcolepsy. Some general guidelines are necessary, with input from clients and family to individualize any special requests with assistance from the facility. a. Which task should the nurse take responsibility for completing? b. I can detect the presence of carbon monoxide by a metallic odor 3. Which task would be appropriate for the nurse to assign to the unlicensed assistive personnel (UAP)? 4. Involve the client in their plan of care. However, this client would not need to be seen prior to the client with potential neurovascular compromise from a cast that is too tight. The RN will also need to be in communication with the assisted living facility to ensure that they have are a support system for the patient and her follow up care with her pacer. D. b. a. d. Services are centered in long-term care facilities, a. c. Holds the soiled linen against her body while carrying it to the linen bag Triage and assign color-coded tags to each client. d. Highly concentrated urine, 91. Handoff and Nursing Report Sheet. A nurse is completing discharge teaching with a client. 3. b. Headache following this procedure is a potential side effect and would not be the priority concern for the nurse. Receive report from the emergency department (ED) on a new client. A nurse is developing a plan of care for a client who does not speak the same language as the nurse. A lack of rapid eye movement (REM) sleep a. Transfer essential medical record to the receiving facility. 4. Cardiac catheterization with a decreased pedal pulse below insertion site. 2. A nurse is prioritizing care for two clients at the start of the shift. 28 week gestation of bed rest, postpartum with HELLP syndrome, breast reconstruction. d. Breathing in carbon monoxide can cause headaches and nausea, c. Take the client to the bathroom every 2 hr (this establishes a regular pattern of toileting and the client learns to trust that the staff will place value on his bladder-training needs), 59. This center functions as 'information central', where all plans or activities are coordinated and determined by those personnel. The nurse is planning care for a client admitted with Alzheimer's Disease. The situation should be explored before bringing the supervisor in on the situation. d. Social conversation, a. Respite care provides holistic support and care for a client who is terminally ill Select all that apply. Select all that apply A client requesting assistance packing his belongings for discharge later today., A nurse is adhering to standard precautions while caring for a group of clients. A nurse in a dialysis center is caring for a client who has a new diagnosis of end-stage kidney disease. American Sickle Cell Anemia Association The nurse chooses to confront the client. 2. 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. b. I will bear the weight of my body on my hands A nurse is filling out an incident report after finding a client lying on the floor. 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. a. I will begin 48 hr before the client's discharge Which of the following actions should the nurse take? Which of the following actions should the nurse take first? However, it remains true pain for this client and the client would need intervention to help manage this pain. b. 3. Which of the following responses should the nurse make? d. Custard A. b. 4. The client is getting better. Use double bagging to remove soiled linen from the client's room This assumption is not appropriate, and the feelings and concerns of the client should be addressed. This situation is considered an external disaster which means the hospital will be expecting multiple victims. Assist a client to ambulate using a gait belt 6. Which of the following statements should the nurse make? Select all that apply Correct: The LPN/LVN can monitor for behavioral changes and can look for potential safety hazards. Only a plain enema or soap enema can be given by the UAP. Drag and Drop the items from one box to the other. c. To determine the client's electrolyte balance A nurse is planning to discharge a client who has quadriplegia to his home. (Sclect all that apply) A. Bathe a client who had an amputation 2 days ago. 1. Correct: A medical-surgical LPN would likely have seen and cared for diabetics on the floor, including checking fingerstick blood sugars and injecting insulin. Incorrect: The client does need to have food; however, there is another action that should be performed first. Select all that apply. Incorrect: The nurse can measure vital signs; however, agency policy usually states that UAP can perform this task also. Channel The charge nurse is developing patient care assignments for the evening shift and needs to assign clients to a licensed practical nurse/licensed vocational nurse (LPN/LVN) and a certified nursing assistant (CNA). Incorrect: Volunteering to take a client would add more work to the charge nurse when this might not be necessary. 4. Announce the new changes at the monthly staff meeting. Correct: A long term care facility is considered a client's "home environment", and families are encouraged to visit often. a. 5. The client with cystitis is stable and has a predictable outcome. a. I wish I didn't have to attach the electrodes to my skin Place in priority order. Ambulating a client who is 2 days post vaginal hysterectomy 1. 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. Providing a passive response Which client should be assigned to the most experienced nurse? This client needs careful monitoring and specialized care. Respite care allows the primary caregiver time away from day-to-day care responsibilities, 75. Incorrect: A lumbar puncture involves removing cerebrospinal fluid from the subarachnoid space to diagnose specific diseases or the presence of bacteria. is a new graduate in orientation. a. Turning off continuous tube feeding to reposition a client, then turning the feeding back on. Which of the following findings should the nurse identify as a safety risk? 1. The nurse is responsible for the assessment of all vital signs of post-op clients. b. Negligence a. This service focuses on teaching the primary caregiver to meet the client's needs As part of an annual physical examination a nurse is preparing a client to undergo a chest x-ray. Correct: The client may be experiencing a myocardial infarction and requires further assessment. 1. Which of the following tasks should the nurse delegate to unlicensed assistive personnel (UAP)? Incorrect: A client who has a spinal cord injury and is in rehabilitation is still alert and able to make decisions. c. Inflate the balloon when the urine flow stops (Select all that apply.) d. Complete an incident report, 70. The first client the nurse needs to assess is the elderly client admitted 30 minutes ago with reports of constipation for four days. Which of the following actions should the nurse take? Incorrect: This group of clients needs specialized care. a. If your reasons for refusal were client safety, nurse safety, or an imperative personal commitment, document this carefully including the process you used to inform the facility (nurse manager) of your concerns. Select all that apply Complete a neurological check (appropriate nursing intervention when a client displays sudden confusion). d. Message, 67. 3. Placing the traction weights on the bed to transfer the client to x-ray. 2. 4. _____The house that we lived in for nine years has been sold. Client diagnosed with inoperative brain tumor who is confused. A nurse is caring for an older client who is at risk for skin breakdown. Incorrect: This is appropriate because this position will improve gas exchange and breathing for a client after thoracic surgery. The nurse who made the medication error should take which of the following actions first? 2. Who should the nurse see first? TRAINED TO BE RELIEF CHARGE NURSE FOR THE UNIT, COMPLETE PATIENT ASSIGNMENTS, CUSTOMER SERVICE AND PROBLEM-SOLVING PROFICIENCY JUNE 2021 - JUNE 2022 STAFF RN - 3C GI MED SURG PROFICIENT IN . This client is at a high risk of infection. d. I decline this opportunity at this time, b. 3. b. Urinary frequency for several days a. 4. Each ROM movement should be repeated 5 times during the session. 3. Which of the following responses should the nurse make? The client with chronic emphysema has expected shortness of breath. 4. 1., 2., 4., & 5. A client post pacemaker insertion, awaiting discharge instructions. However, each unit must have one designated representative to send to the command center, when requested, to receive and then relay, pertinent information back to the unit. a. Something new could have occurred with the clients, making the assignments too heavy. Elderly client who fell and fractured the left femoral neck. Client reporting a headache and has a fruity breath. Ask for any staff objections to rearranging work hours. Donning gloves and using a gauze pad to grasp and remove dentures Provides day to day direction and supervision to assigned direct patient care staff. b. I'll rewrap my ankle starting from the knee down Turn on local news for up-to-date information on the train derailment. b. Summarization Which of the following client statements should indicate to the nurse the need for additional teaching? A 10 year old school-age child would also be more cooperative, making it easier for the LPN to interact with that client. d. Apply cornstarch to keep the skin dry, b. Wash the area of the puncture thoroughly with soap and water (the greatest risk to this client is injury from any bloodborne pathogens on the needle therefore the first action the nurse should take is to provide immediate first aid), 28. 1., 4., & 5. Which client can be assigned to the LPN? Write N next to the nonessential clauses and E next to the essential clauses. 1. 5. 2., 3. A nurse is providing discharge teaching about clean intermittent self-catheterization for a client who has a benign prostatic hyperplasia. 1., 2., 3., & 4. Open communication and brainstorming sessions in which staff can freely share thoughts or ideas creates a positive work environment while helping decrease dissatisfaction. It is quicker to administer medications intravenously in the hospital Incorrect: The first void of a 24 hour urine is discarded and can be delegated to the UAP. b. Incorrect: When a unit is very busy, the nurse should rely on the UAP if the person is competent to perform the tasks. Incorrect: Aplastic anemia is a blood disorder in which the body's bone marrow doesn't make enough new blood cells. *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. Client #5 -It is considered within the scope of practice for an LPN/LVN to monitor a transfusion of a blood product. Which of the following statements should the nurse identify as an indication that the client understands the instructions? Select all that apply 5. Left upper forearm Incorrect: The administration of parenteral pain medications is not in the scope of practice for the LPN/LVN. -Review a low-sodium diet for a client who has HTN Point out inconsistences in the client's behavior (a nurse using confrontation helps the client become aware of inconsistencies in his feelings, attitudes, beliefs, and behaviors. Therefore, this client needs the advanced assessment skills of the RN and should not be assigned to the LPN. 2. A goal for this client is to use proper body mechanics at all times. So, the UAP can assist a client to brush and floss teeth. Which of the following approaches should the nurse use when using confrontation? 4. We see that the temperature is already elevated, which makes us worry that infection is present. These individuals are selected by the charge nurse, and do not have to be nurses. c. I will make sure my visitors smoke outside Which of the following tasks should the charge nurse reassign to a licensed nurse? Teach caregivers memory enhancement aids. 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. 4. 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. & 3. 1. 3. a. Complete blockage of the large intestine. 4. Start MgSO4 at 3g/hr IV A nurse is teaching a client about carbon monoxide poisoning. Besides yourself, there are the following staff: Your unit has 12 beds. Reach around the pack and open the top flap away from the body, 53. Which of the following responses should the nurse provide? & 6. 3. Check environment for potential safety hazards. Prepare a list of clients who could quickly be discharged or transferred. Incorrect: Most adults have already been exposed to the virus and are not at risk for adverse effects of the infection. b. Dons gloves to empty a urinary drainage device Incorrect: This group of clients needs specific teaching. b. Client one day post kidney transplant. 4. Find a mentor Most nurses learn to make nurse-patient assign-ments from a colleague. This would be an acceptable task to assign to the UAP. For Option #3, you may have recognized MgSO4 as being magnesium sulfate. 3. with this question, the nurse is using which of the following communication techniques? Once the client is stable, the UAP could perform this task. (Select all that apply.) Did you recognize ureterolithiasis as "kidney stones"? The charge nurse delegates a licensed practical nurse (LPN) to perform an intervention that is not within the scope of practice for the LPN. A nurse is caring for a client who receives intermittent enteral feedings through an NG tube. b. Even though this nurse just had a baby, there is no risk of her transmitting this virus to her child. A high concentration of carbon monoxide can cause death The nurse also needs to be aware of the color and amount of urine voided. A nurse in a clinic is caring for a client who reports pain, crepitus, and a popping sound is his temporomandibular joint. 1. A newborn is admitted to the nursery with a diagnosis of rule out cytomegalovirus (CMV). Making patient assignments is an important charge nurse role that lacks theoretical support and practical guidelines. a charge nurse is making client care assignments for the day. a. b. 1 Ask client if they are eating small, frequent meals. The nurse should call for immediate help so that a safe care environment is maintained for all clients. Also, making a surgical bed for the client returning from surgery is a basic procedure. Give magnesium citrate 296 mL at 3 PM today. "The client is weak on the right side, so please assist the client with dressing . Diltiazem is a calcium channel blocker that has been ordered as a titrated drip to slow heart rate and restore a regular rhythm. Which task is appropriate for the nurse to delegate to the experienced nursing assistant? c. I'll clean the inside of the container with a wipe d. principal. A nurse is caring for an older adult client who has a fractured hip and will require rehab care. Incorrect: This option would create total chaos, interrupting sleep patterns and staffing schedules. c. I will begin upon the client's admission to the facility Personal liability coverage is not mandatory, but you should consider purchasing your own coverage, 87. Observe the client before taking further actions A charge nurse is making client care assignments. d. Request a prescription for an indwelling urinary catheter, c. I will begin upon the client's admission to the facility (effective discharge planning must begin upon admission of the client to the facility), 60.