The best practice committee works to improve clinical practice based on current research. What is the appropriate assignment? 3. Some general guidelines are necessary, with input from clients and family to individualize any special requests with assistance from the facility. The second client that needs to be seen by the nurse is the client having weakness, a sign of hypoglycemia. Which task would be appropriate for the nurse to assign to an unlicensed assistive personnel (UAP)? Incorrect: The client does need to have food; however, there is another action that should be performed first. The client will need to be assessed, but there is no specific indication the respiratory status is presently compromised. 3. The client is getting better. 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. A client with epilepsy reporting an odd smell in the room. 2. c. The restraints should promote the client's safety and prevent injuries Correct: Disconnecting NG tube suction is an appropriate task for the UAP. d. Discussing intake and output Richied5864 Richied5864 . c. Hold an object away from her body as she lifts it 6. b. I will come back later and we can talk 77. This stage is when testing occurs to identify boundaries of interpersonal behaviors The stem does not indicate any loss of neurological function resulting from the seizure activity. The nurse considers various ideas submitted by team members. Respite care provides holistic support and care for a client who is terminally ill e. Feed a client who had a stroke 3 months ago, 31. The charge nurse is planning assignments on a medical unit Which client d. Resistance is evident as subgroups form in this stage, c. Discard the tablet and obtain another dose of medication, 35. What is the best care assignment for this client? Incorrect: If alcohol or drug dependency is suspected, confrontation will result in hostility and denial. c. imaginary Incorrect: Emergency room nurses deal with life threatening emergencies but are not specialized in the care of clients with preeclampsia. Correct: A long term care facility is considered a client's "home environment", and families are encouraged to visit often. The RN with 5 years' experience in the Labor and Delivery unit. Therefore, this client would not be a priority over a client who may be experiencing a MI. & 4. A charge nurse is planning client activities for the day. A person can be designated to make medical decision in the event the client cannot. INCORRECT: Although the vascular status of the foot will need to be assessed, there is no indication if the debridement has been completed yet. Incorrect: When a unit is very busy, the nurse should rely on the UAP if the person is competent to perform the tasks. Correct: The nurse should recognize that this child has a very low absolute neutrophil count (ANC), which is referred to a neutropenia. 1. b. b. I will begin once the client's discharge order is written This client is not the nurse's first priority. This center functions as 'information central', where all plans or activities are coordinated and determined by those personnel. Client scheduled for breast reconstruction after mastectomy. Tenderness over the symphysis pubis 4. b. This action is a defensive intervention, and does not address the quarrelsome behavior. Ask the charge nurse to evaluate the intervention. Sudden attacks of sleep There are a total of 10 adult clients. Occupational therapist They have found my address and are coming for my family!" The client says, "go away, no one can help me." Remember airway, breathing and circulation (ABCs). Correct: The nurse has not been able to determine the skill of vital sign assessment for this new UAP. The client states, "I'm feeling a bit nervous today." Covering open wounds will help to decrease bacterial exposure until the registered nurse or primary healthcare provider can assess and treat each wound. Notify the board of nursing (BON) that the float nurse is an alcoholic. Which client should be assigned to the most experienced nurse? 5. 2. 2. b. 4. This would be out of the UAP's scope of practice. The nurse has another priority. What proposal would the nurse determine to best meet the needs of families and clients in long term care? 1. The body needs vitamin B12 to make red blood cells. The RN with 10 years' experience pulled from the ER. During lunch, Robin jotted a letter to Amy and signed it, "your friend, Robin.". 2. a. A nurse is preparing medication for a client when another client has an emergency. d. Explain oral hygiene to a client receiving chemo Which of the following types of communication breakdown does this response represent? c. I will complete the smoking cessation program I started 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. The nurse received a client following surgery 8 hours ago. This perceived lack of control can create distrust and frustration among personnel, ultimately impacting client care. 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. A nurse is planning to discharge a client who has quadriplegia to his home. 3. Notify the nursing supervisor of the situation. So, now you must decide which of these high priority clients should be seen in what order. They are more direct when discussing issues (men focus on issues and discuss them more directly and readily than women do), 20. Which of the following info should the nurse include? The client asks about his medications and their effects. Which pediatric client care assignment is most appropriate for the charge nurse to delegate to the LPN/LVN? Incorrect: The hysterectomy client needs to be ambulated to avoid post op complications. 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. 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. Airborne A nurse is implementing direct nursing care for a group of clients in an acute care facility. Read all the current literature related to oral care on unresponsive clients. Incorrect: The wash cloth is placed in the sink to prevent the dentures from breaking if they are dropped. The nurse can accept the assignment, documenting your personal concerns regarding working conditions in which management decides the legitimacy of employee's personal concerns. 1. 3. Nothing will get passed the complete blockage. Practice Leadership Exam for Nursing - A charge nurse in an - StuDocu The nurse should not lecture, scold or argue with the float nurse. Place in priority order. The surgeon initially prescribes a clear liquid diet. This includes medication enemas. Incorrect: By encouraging the client to be more cooperative, the nurse is denying the client's feelings and concerns. A nurse is having difficulty caring for a client due to variables affecting the communication process. 4. Twist at the waist when she moves an object to one side If the LPN notes any serious bleeding situations, it would need reported immediately to the RN. If you are new to this challenge, try these eight tips as a guide for making nurse-patient assignments. Which of the following methods should the nurse plan to use? 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. Incorrect: This is doing research, which requires the research process be implemented, including appropriate approval. Which of the following should the nurse include as a criterion for applying restraints? Nothing life threatening. Which of the following indications should the nurse include? Incorrect: This response overlooks a potentially severe problem. The cause of the fall may be cardiac, but the question does not indicate this. 4. a. No! A client requesting assistance packing his belongings for discharge later today.. (b) H3O+(aq)+OH(aq)2H2O(l);K=1.01014\mathrm{H}_3 \mathrm{O}^{+}(a q)+\mathrm{OH}^{-}(a q) \longrightarrow 2 \mathrm{H}_2 \mathrm{O}(l) ; K=1.0 \times 10^{14}H3O+(aq)+OH(aq)2H2O(l);K=1.01014 c. Tie linen bags securely at the top The client reports constipation for 4 days which may be an indication of worse problems. What would the approximate meaning of photoelectric be, based on these root words? Monitor for GI upset 30 minutes after meals. Which of the following interventions should the nurse use to help maintain the integrity of the client's skin? Everything will be okay d. Voided 30 mL frequently Assuming that dissolved reactants and products are present at 1 M concentrations, which of the following reactions are nonspontaneous in the forward direction? A charge nurse is making client care assignments. c. Helping the client into the shower The provider must renew a restraint prescription every 8 hr. 3. These areas require the expertise of an RN and would not be appropriate for an LPN/LVN. 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. a. one of the licensed practical nurses Get the answers you need, now! b. Which of the following pieces of PPE should the nurse remove first? Which of the following communication techniques should the nurse use during this phase? 4. c. Open the right flap with the left hand a. A nurse is teaching a client about the physical effects of chemotherapy. Left upper forearm Assigning blame for the changes to administration will not help staff adjust. 4. Correct: Talking to the nurses about client concerns and completing the client assignment sheet for oncoming staff will provide for a thorough shift change report. 212 A nurse is preparing to move a client who is only partially able to assist up in a bed. I am feeling much better since my discharge from the hospital and I think my kidneys are working again." c. I'll need to shave the hair off the skin where I place the electrodes Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. a. The nurse asks the client, "Are you feeling anxious about the results of your colonoscopy?" 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. Two hours . 1., 2., & 5. For which of the following tasks should the nurse wear protective eye equipment. Lisinopril 20.0 mg PO daily b. Which task is appropriate for the nurse to delegate to the experienced nursing assistant? Serve food that have a hot/cold balance Although this will require assessment, this client is not the priority at this time. Provide an adaptive feeding device for the client, 50. a. Incorrect: This again is assessment which is the role of the RN only. 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. Incorrect: This group of clients needs specific teaching. The third client that should be assessed by the nurse is the client diagnosed with hemorrhoids who had some spotting of bright red blood on toilet tissue with last bowel movement. Provides day to day direction and supervision to assigneddirect patient care staff . Select all that apply.