Which of the following RNs should not be assigned to this baby? c. Face shield a. The charge nurse on the postpartum unit is making assignments. They are able to manage tasks related to basic care. Furosemide 40 mg PO q.d. Incorrect: Pernicious anemia is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12. Client who is a diabetic experiencing diabetic neuropathy. leadership management of care nurse on unit is providing care for group of clients. b. a. I wish I didn't have to attach the electrodes to my skin a. 2. c. Review another client's similar surgical experience Performing passive range of motion (ROM) on the client with right sided paralysis. 4. 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. 2. c. Gender 1. Incorrect: Informing is the same thing as teaching. 4. Thoracentesis reporting shortness of breath. A copy of select parts of the medical recording, according to facility policy, is another form of communication that will support continuity of care. Which of the following client statements indicates an understanding of the procedure? Teaching can be reinforced by the LPN/LVN, but they cannot perform the initial teaching. Which of the following of Erikson's developmental stages should the nurse consider in the planning? Incorrect: An Advance Directive is a written, legal document regarding preferences for medical care should a person become unable to make medical decisions. Correct: The client who has a cast and requires pain medication is a stable and predictable client. Therefore, this client would not be a priority over a client who may be experiencing a MI. Incorrect: Passive ROM is performed with paralysis and can be delegated to the UAP. 1. Call the client's provider Diltiazem is a calcium channel blocker that has been ordered as a titrated drip to slow heart rate and restore a regular rhythm. (Sclect all that apply) A. Bathe a client who had an amputation 2 days ago. Turning off continuous tube feeding to reposition a client, then turning the feeding back on. d. Clients are placed on artificial life support before organ and tissue donation can occur, a. I'll sit with my knees lower than my hips (client should sit with knees slightly higher than their hips to prevent injury), 24. c. Physical therapist Cleanse the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen Incorrect: This is a nursing responsibility and the best practice committee is the best place to begin. Incorrect: This again is assessment which is the role of the RN only. assignmentcafe.com - A charge nurse is making assignments for nursing The surgeon initially prescribes a clear liquid diet. b. c. We administer all medications intravenously to clients in this unit Assess personal level of fatigue prior to making a decision regarding accepting or refusing assignment. A nurse is teaching a client who has strained her back muscles while preparing to move to a new apartment. Place in priority order. b. Assigning tasks to an AP 1. Soaking the dentures in hot water c. Surgeon (the health care provider who will perform the treatment or procedure is responsible for obtaining informed consent from the client). 2. Each unit functions differently, but the charge nurse's role is to make the unit run smoothly. (Select all that apply.). Teach caregivers memory enhancement aids. The charge nurse is making client assignments for a neuro-medical floor. a. I'll provide more stimulation in his environment Ask the primary healthcare provider to suggest the best oral care procedure. 1. This may result in several health problems including arrhythmias, an enlarged heart, heart failure, infections and bleeding. To which of the following rooms should the nurse assign the client? Pernicious Anemia Society 1. Besides, a charge nurse is a leader on the floor and should possess . CORRECT: The client is potentially experiencing symptoms of an impending seizure, which can include seeing halos around lights or detecting odd smells. A nurse instructs a female client about collecting a midstream urine sample. Determine caregiver's stress level and coping strategies. 4. a. Auscultating heart sounds M2.4 Making Client Care Assignments - GECC.pdf - Course Hero a. b. d. Wears a respirator mask when entering the room of a client who requires airborne precautions, c. Industry vs inferiority (a school age child (6-12) is in this stage of development), 12. Client admitted 24 hours ago with a diagnosis of a stroke, who is now reporting a headache that intensifies when moving in the bed. Irrigate a client's ear canal. *HURST REVIEW Qbank/Customize Quiz - Leadership Ask the float nurse, "Have you been drinking?" It also helps the client deal with issues that are important to him), 19. Correct: A medical-surgical LPN would likely have seen and cared for diabetics on the floor, including checking fingerstick blood sugars and injecting insulin. The charge nurse delegates a licensed practical nurse (LPN) to perform an intervention that is not within the scope of practice for the LPN. It can develop suddenly or slowly and tends to worsen with time, unless the cause is found and treated. If a sentence is already correct, write CCC. 4. Since the enema would clean below the obstruction, the client would be able to expel the enema and any feces in this part of the colon. A nurse is planning to discharge a client who has quadriplegia to his home. 2. A nurse is completing discharge teaching with a client. This referral would be appropriate. Incorrect: The purpose of a cystogram is to examine the inside of the bladder to confirm the presence or absence of abnormalities, or even obtain a biopsy. The abdominal pain is worsening. 1. These individuals are selected by the charge nurse, and do not have to be nurses. This client is at a high risk of infection. Which referral would most likely be appropriate for the nurse to make? After making initial assessment rounds on assigned clients in the morning, the RN tells the charge nurse that the clients are too difficult. It can result in muscle spasm and tissue damage. Question: A charge nurse is making client care assignments. 2. Temporary urinary retention (common for clients to develop after removal), 90. Which of the following interventions should the nurse include? Notify the primary healthcare provider of transfer completion. e. Dysuria, 49. 5. Discussing a client's surgical procedure with the nurse manager c. Request a tray without pork Which of the following statements should the nurse identify as an indication that the client understands the discharge information? It is quicker to administer medications intravenously in the hospital a. I will keep my walker at the end of my bed The second client that should be given a treatment room is the elderly client who fell and fractured the left femoral neck. c. Confrontation d. To identify delayed gastric emptying, a. Auscultate breath should at least ever 2 hr (priority action the nurse should contribute to the plan of care when using the ABC approach to client care in auscultating breath sounds to determine the client's need for suctioning; with inactivity, secretions can pool in the airways, diminishing breath sounds and causing crackles and dyspnea), 43. a. c. Leave a nightlight on in the client's room b. Numbness 1. Sit side-by-side with the client A school-aged child with a fractured femur who is in balanced suspension traction. The nurse prefers to check all vital signs on all clients. Incorrect: A client scheduled for surgery after a mastectomy is still able to make decisions. Correct: If suspicious behavior occurs, it is important to keep careful, objective records. Incorrect: Discussing the assignment with another LPN is delaying the client's needed intervention. In this situation, it is not a matter of the nurse preferring to take all the vital signs, but the nurse needs to know the competency level of the UAP before delegating this task. Incorrect: The charge nurse should first obtained the needed information and then decide whether to notify the nursing supervisor. d. Arguing, a. I'll apply ankle to my ankle today and tomorrow (the RICE acronym outlines how to treat an ankle sprain: rest, ice, compression, elevation), 16. What task would be appropriate for a nurse caring for a client diagnosed with gastroesophageal reflux to delegate to an unlicensed assistive personnel (UAP)? 2. 5. b. The nurse is reviewing some clients' prescriptions. (Select all that apply.). b. Donation costs are the responsibility of the donor's family and estate d. Reflection, c. Leave a nightlight on in the client's room (night vision may be impaired in older clients; a nightlight may help client recognize their surroundings and decrease the likelihood of disorientation), 37. Incorrect: This client is post cardiac catheterization and remains on bedrest; therefore, the affected leg must be kept straight to prevent femoral hemorrhaging. The best practice committee works to improve clinical practice based on current research. 2. Semi-formed stools are great news! Family cannot withdraw the Advance Directive and make decisions that go against the client's wishes made within the document. Asking for an explanation A nurse accidentally sticks her hand with a syringe needle after administering an IM injection to a client. The responsibility of the nurse manager is to implement change in a positive manner, while assisting staff adaptation even to unpopular modifications. b. The client with chronic emphysema has expected shortness of breath. Following a passenger train derailment, local hospitals are notified to activate disaster protocols on all floors. Client who requires teaching about the use of a patient-controlled analgesia (PCA) pump. Decreased RBC production INCORRECT: There is no information regarding how recent was the surgery or the degree of pain being experienced. Incorrect: The client does need to have food; however, there is another action that should be performed first. 28 week gestation of bed rest, postpartum with HELLP syndrome, breast reconstruction. Incorrect: Teaching is outside the scope of practice for the LPN/LVN. Involve the client in their plan of care. Client diagnosed with a hemorrhagic stroke 1 week ago, who currently has a blood pressure of 170/96. 3. 4. Incorrect: This is doing research, which requires the research process be implemented, including appropriate approval. c. The restraints should promote the client's safety and prevent injuries Notify the nursing supervisor of the situation. The nurse should use close-ended questions when assessing which of the following factors? A nurse is working with an LPN to care for a client who is receiving a continuous IV infusion. 3. a. Respite care allows the primary caregiver time away from day-to-day care responsibilities Select all that apply. In which situation should the nurse consult the client's advanced directive? c. Use an aggressive tone of voice A nurse is orienting a new assistive personal (AP) to the unit. c. I will place an area rug at the entry of my bathroom Documentation of what occurred, and the client's assessment is required in the nurse's notes. Ask the charge nurse to evaluate the intervention. Licenced practical nurses are a little less educated than registered nurses. Therefore, measures should be instituted to reduce the risk of the development of an overwhelming infection and sepsis. Client with arthralgia who is receiving regularly scheduled pain medications and has warm compresses prescribed. Client who has multiple injuries from a motor vehicle accident. 4. Assist client to brush and floss teeth. Select all that apply c. I'll wear low heeled shoes from now on e. Suctioning a client's new tracheostomy tube, 93. A nurse in a long-term care facility is observing an AP changing the linen for a client who has fecal incontinence.