4. 3. Use adult diapers to prevent frequent clothing changes The RN with 8 years' experience in the Intensive Care Unit. a. d. Resistance is evident as subgroups form in this stage, c. Discard the tablet and obtain another dose of medication, 35. Assist the float nurse with the clients case. A nurse is caring for a client in the orientation phase of the nurse-client relationship. Wears a gown when entering the room of a client who requires contact precautions A nurse is preparing an education presentation about organ donation for a group of newly licensed nurses. Which of the following actions should the nurse take? Place the client in low Fowler's position 4. The charge nurse on each unit needs to prepare a list of possible discharges or transfers to be given to the appropriate primary healthcare providers for further action. 4. Draining of the bag is a routine toileting procedure for the colostomy client and.is within the scope of practice for the UAP. a. When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb vitamin B12. Obtain a bedside commode for the client's use There may be a good reason that the tray was not served. 1. This documentation should go to your manager. b. Irrigate the wound with an antiseptic prior to obtaining the specimen Correct: The client has the right to be involved in the decision making of their care. Following a large hurricane, multiple clients arrive at the emergency room for treatment. The spouse can rescind the Advance Directive if the client becomes unresponsive. Notify the charge nurse of the observations. Obtain a client's consent c. Changing a dressing The stem does not indicate any loss of neurological function resulting from the seizure activity. 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. This situation needs advanced monitoring and care, so this nurse with very little postpartum experience would not be the most appropriate to assign to this client. leadership management of care nurse on unit is providing care for group of clients. c. I will place an area rug at the entry of my bathroom 5. Determine which personnel could be sent to the command center. 1. 2. The nurse should base her pain management interventions primarily on which of the following methods of determining intensity of the client's pain? This item: Nursing Brain Sheet Multiple Patient Notebook - Nurse and CNA Report Sheet - 3 Patients per Template $1999 BadgeGuru by Tribe RN - 52 Cheat Sheets on 26 Nurse Badge Cards - Designed by Nurses, for Nurses - Essential for Nurses and Nursing Students - Bonus Access to Our Digital Resource Library - Inverted $1997 ($0. This would be an acceptable task to assign to the UAP. Which observation of denture care by the unlicensed assistive personnel (UAP) would require the nurse to intervene? Remind the client to tell the nurse when he has to urinate Write the letter of your choice on the answer line. 3. A nurse caring for a client is using active listening skills. Focus on the client's present circumstances instead of his personal stories The client can indicate desire for Do Not Resuscitate (DNR). Client two days post percutaneous endoscopic gastrostomy (PEG) placement. a. Which of the following actions indicates that the AP understands the principles of infection control? 3. Correct: Did you notice the hint? Confrontation should occur in the presence of a charge nurse or supervisor. Client to receive dietary education. 4. A nurse is assessing a client who has narcolepsy. A charge nurse role includes front line nurse supervisor, resource nurse, bed manager, peer reviewer, patient advocate, other charge nurse duties, and staff scheduler. 2. e. Feed a client who had a stroke 3 months ago, 31. 3. b. e. Dysuria, 49. A nurse identifies a pressure ulcer after a client had a long, extensive recovery following a surgical procedure. Have another nurse finish preparing the medications Client #1 has COPD, and, although complaining of shortness of breath, that is not unusual for clients with this diagnosis. What is the primary factor for the charge nurse to consider when delegating care? This service began with the client's admission to the hospital, 18. Turn on local news for up-to-date information on the train derailment. C. Review a low-sodium diet for a client who has hypertension. The charge nurse might not have realized all the responsibilities of taking this team of clients. Airborne This could cause a medical emergency. 3. 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). Refuse the delegated intervention. "The client is weak on the right side, so please assist the client with dressing . 2. Electric cords behind the furnitrure A nurse in a clinic is teaching a group of clients about preventing low back pain and injury. Fruity breath. 4. A nurse asks a client how he is feeling. c. The restraints should promote the client's safety and prevent injuries Ask the float nurse, "Have you been drinking?" 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. Providing hygiene care to a client who is HIV positive Correct: A long term care facility is considered a client's "home environment", and families are encouraged to visit often. 1., 4., & 5. Hearing loss There are a total of 10 adult clients. ATI Leadership and Management Questions - Leadership Management of Care If the decimal point is missed in this situation, the client could receive 5 mg instead of the intended dose of 0.5 mg of risperidone. Perform range of motion (ROM) exercises at least 2-3 times daily b. b. 3. Also, making a surgical bed for the client returning from surgery is a basic procedure. a. I will be able to tell how much oxygen I'm getting by looking at the flowmeter Aplastic anemia is a rare but serious condition. Flashcards - chapter 7 - FreezingBlue 1. This service began with the client's admission to the hospital Therefore, the nurse with the labor and delivery experience would be more appropriate to assign to this client. 1. Incorrect: Since this client has an obstruction, anything the client eats will not be able to come out. For which of the following tasks should the nurse wear protective eye equipment. a. The client attempted to climb over the side rails and fell Discuss the issue with the leader of the "best practices" committee. A nurse is teaching a client about carbon monoxide poisoning. Select all that apply. d. Have the client practice blood-glucose monitoring using a glucometer, d. When asking if the client took his medications this morning, 81. Cleanse the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen 5. Even though this nurse just had a baby, there is no risk of her transmitting this virus to her child. Which of the following pieces of PPE should the nurse remove first? a. Now, in Option #2, we see a dangerous prescription. c. Review the client's progress toward personal objectives It's unfortunate that I have to be in the hospital for this treatment Correct: Positive feedback is an effective communication tool that improves the workplace environment and encourages individual achievement, particularly in challenging situations. Assist a client to ambulate using a gait belt. A client requesting assistance packing his belongings for discharge later today.. 4. Occupational therapist (an occupational therapist assists clients who have physical challenges to use adaptive devices and strategies to help with self-care activities such as feeding). Allowing staff to vent is acceptable but the nurse manager should focus on constructive methods of adjustment to the impending mandated changes. Which of the following actions should this nurse take? Administer tap water enemas until clear at 6 AM. In sickle cell anemia, the red blood cells become rigid and sticky and are shaped like sickles or crescent moons. Incorrect: The first void of a 24 hour urine is discarded and can be delegated to the UAP. Hormone replacement does not affect the immune system and, therefore, this nurse is not at risk for infection from CMV exposure. The healthcare team should recognize the client as the center of the team. Notify the surgeon that the client wishes to withdraw informed consent for the procedure c. Use an aggressive tone of voice a. An experienced person who can research "best practice" regarding the issue is needed. 6. a. A nurse is caring for a client who is discussing his post-traumatic stress disorder and states: "Everyone thinks you should be able to put it out of your mind. b. Assist client to brush and floss teeth. e. Throw rugs, 40. Something new could have occurred with the clients, making the assignments too heavy. A nurse in a long-term care facility is caring for an older client who has dementia and begins to have frequent episodes of urinary incontinence. 2. A charge nurse is making client care assignments. The nurse should assess the client for which of the following expected outcomes after catheter removal? This referral would be appropriate. 2. a charge nurse is making client care assignments for the day. which A Charge Nurse Role: The Ultimate Guide. Drag and Drop the items from one box to the other. Comatose client with end stage chronic obstructive pulmonary disease. Which of the following actions is the priority for the nurse to include in the client's plan of care? Plan all care to be completed in early morning to allow afternoon for visitation. Incorrect: Moistening the dentures will ease insertion. Photo comes from the Greek word for light. Empty the drainage bag at least every 8 hrb.) Allow families unlimited visitation around the clock to meet their schedules. Occupational therapist c. Lock the medication in a room and finish preparing it after returning from the emergency Correct. 1. When the licensed person cannot determine this, the task should not be delegated. The nurse is using which level of communication at this time? Taking the report from the ED could be delayed but is a courtesy to the ED and will provide information about the client that will be useful in making assignments for the next shift. Correct: Assisting clients with activities of daily living are within the UAPs scope of practice. Complete a neurological check (appropriate nursing intervention when a client displays sudden confusion). a. A client post pacemaker insertion, awaiting discharge instructions. d. Explain the procedure to the client if they do not understand, c. Lock the medication in a room and finish preparing it after returning from the emergency (securing them and returning later to finishing preparing and administering them decreases the risk of medication errors), 72. a. A nurse is providing discharge teaching for a client who requires home oxygen therapy. 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. 4. 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. The charge nurse is determining morning care assignments for several elderly clients awaiting discharge to an assisted living facility, including a client on bed rest with a skin tear and hematoma from a fall 5 days ago. Nurses dependent on drugs or alcohol can harm clients. A nurse is rehearsing assertive communication approaches to use when declining leadership of a nursing department committee. Incorrect: This group of clients needs specialized care. 2. A nurse is preparing medication for a client when another client has an emergency. c. To determine the client's electrolyte balance When reviewing the admitting prescriptions for a client, the nurse notes that the dose of one medication is three times the usual dose of this medication. The charge nurse should notify the nursing supervisor who will seek additional staff. A charge nurse is making client care assignments. Feedback Incorrect: Obtaining the urinary output of a client at the end of the shift is appropriate for the nursing assistant and should be documented and reported to the RN. A client with diabetes admitted for debridement of a foot ulcer. assignmentcafe.com - A charge nurse is making assignments for nursing Who should the nurse see first? b. A nurse asks a client to share personal stories. 3. 4. A skill for which the ap has received instruction the - Course Hero c. Visual observation for nonverbal signs of pain Announce the new changes at the monthly staff meeting. Provide positive feedback to the UAP. 1. Charge Nurse - RN | Fresenius Karriere The abdominal pain is worsening. c. We administer all medications intravenously to clients in this unit Drag and Drop the items from one box to the other. Elderly client who fell and fractured the left femoral neck. What is the best care assignment for this client? c. Hallucinations at the onset of sleep The client was lying on the floor next to his bed a. The nurse is evaluating care provided by an unlicensed assistive personnel (UAP). 3. c. Do not eat or drink anything the morning of the test }? benefactor of the world. 3. 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. 5. a. c. 214 Include any relevant statements the client made about the ulcer, 64. A nurse wants to find out a better way to perform oral care on unresponsive clients. Which of the following actions should the nurse take? Personal liability coverage is not mandatory, but you should consider purchasing your own coverage, 87. A nurse is creating a discharge plan. 4. Which of the following infection-control precautions should the nurse use caring for this client? & 4. a. 4. On an ongoing basis, the charge nurse evaluates individual and collective outcomes of the patient care provided during their shift, compares patient care delivery to accepted standards, adjusts assignment of resources as necessary, and reports changing needs and outcomes to the health care staff. b. b. Incorrect: Although this action appears to be opening lines of communication, the nurse manager is actually fostering animosity in a situation where the outcome is already predetermined. a. Assigning this nurse to the newborn with CMV would put her unborn baby at high risk for life-long defects and even death. Witness the client's signature Which of the following indications should the nurse include? c. Blood-tinged urine 1. In option #4, we see that the leading zero is missing from the prescription. Find a mentor Most nurses learn to make nurse-patient assign-ments from a colleague. Accept the client's behavior as confrontational. Which response by the LPN is appropriate in response to the inappropriate delegation? Cleanse the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen (nurse should remove all wound exudate and any residual antimicrobial ointment or cream to avoid altering the culture results), 56. Which task would be appropriate for the nurse to assign to an unlicensed assistive personnel (UAP)? 4. Which of the following actions should the nurse take regarding informed consent? Encourage the client to be more cooperative. A nurse accidentally sticks her hand with a syringe needle after administering an IM injection to a client. b. I'll rewrap my ankle starting from the knee down A nurse is orienting a new assistive personal (AP) to the unit. The best practice committee works to improve clinical practice based on current research. Correct: All facilities are required to develop a disaster plan, per JCAHO (Joint Commission on Accreditation of Healthcare Organizations) regulations, though the plans vary. a. The nurse cannot allow the UAP to perform advanced tasks. The area surrounding the insertion site feels warm to the touch 2. Symbolic communication Select all that apply. Education Soaking the dentures in hot water Which of the following findings reported by the LPN indicates to the nurse the client has phlebitis at the IV insertion site? c. I will inspect my crutches everyday for signs of wear What was the rationale for this plan? 3. 4. c. Helping the client into the shower What should the nurse do first? Those residing in long term care facilities benefit greatly from time spent with family or even older friends. Additionally, off-duty personnel may be needed and should be alerted to stand by; however, the command center alone makes the determination whether extra personnel should be called in, or if it would put more individuals in jeopardy. Write N next to the nonessential clauses and E next to the essential clauses. 1., 2., 3., & 4. c. Complete an incident report Evaluate pain relief after narcotic administration. 4. Respite care allows the primary caregiver time away from day-to-day care responsibilities, 75. b. I will call the doctor and get the prescription What task would be best to assign to the LPN/LVN? Client reporting a headache and has a fruity breath. What task would be best to assign to the LPN/LVN? Incorrect: The scope of practice for the UAP encompasses basic personal care needs, ambulating, and taking vitals; however, the nurse must still verify that all tasks are accomplished in a safe manner. a. c. Shivering (shivering is a systemic response to cold therapy as the body attempts to promote heat production), 77. which of the following actions should the nurse perform? Check environment for potential safety hazards. 4. These are appropriate tasks for an UAP to complete. 5. Which action should the nurse interrupt the UAP from performing? 1. Incorrect: Volunteering to take a client would add more work to the charge nurse when this might not be necessary. A nurse is prioritizing care for two clients at the start of the shift. For Option #3, you may have recognized MgSO4 as being magnesium sulfate. 1. 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. The nurse should use close-ended questions when assessing which of the following factors? Remember airway, breathing and circulation (ABCs). Which of the following responses should the nurse provide? Vaginal delivery of fetal demise, C-section with pneumonia, 32 week gestation with lymphoma. a. Incorrect: The RN is responsible for teaching. In the following sentences, circle each incorrectly used lowercase letter. 1. A client receiving a blood transfusion that requires monitoring. A home health nurse is conducting a home safety assessment for an older adult client. 2. d. Otorhinolaryngologist, c. Irrigating a client's abdominal wound 4. d. When asking if the client took his medications this morning, 82. Try different methods of oral care on unresponsive clients to see what works best. When determining if the client is eating a well-balanced diet The nurse also needs to be aware of the color and amount of urine voided. A nurse is caring for a client who states, "I have got to get out of this hospital! a. The area surrounding the insertion site feels warm to the touch, 61. It involves people who are constantly changing-their conditions improve and deteriorate, they're admitted and discharged, and their nursing needs can change in an instant. Prepare a list of clients who could quickly be discharged or transferred. Which group of clients should she assign to the medical surgical nurse? Client diagnosed with inoperative brain tumor who is confused. This will take a lot of time, and the charge nurse can get the information needed from the nurses caring for the clients in order to make appropriate client assignments for the next shift. Phone report to the receiving nurse. b. Select all that apply Incorrect: This client does not have a predictable outcome. Which of the following findings should the nurse identify as a safety risk? A newborn is admitted to the nursery with a diagnosis of rule out cytomegalovirus (CMV). If the client is unstable, the nurse would retain the role of measuring the vital signs. 2. 4. Elevating the head of the bed 30- 40 for the client post thoracotomy Which nurse should be assigned to care for this client? 2. c. The chances of a malpractice suit are minimal as long as you follow our policies and procedures 4. A client on a surgical unit frequently quarrels with the staff. The nurse prefers to check all vital signs on all clients. However, this client would not need to be seen prior to the client with potential neurovascular compromise from a cast that is too tight. Correct. a. Therefore, this would not be the most appropriate nurse to assign to this client. . 1. 3. Respite care allows the primary caregiver time away from day-to-day care responsibilities When assigning nurses to patients, the charge nurse must consider the acuity of the patient's condition, the skills of the nurse, and the availability of other staff members. Allow the UAP to work without supervision. M2.4 Making Client Care Assignments - GECC As the RN charge nurse, you are preparing to make assignments for the oncoming shift on the medical-surgical unit. c. Interpersonal (interpersonal communication is face-to-face interaction with another person. Of my three brothers and sisters, my sister Giselle has the best sense of humor. The client's self-report of pain severity d. Question the charge nurses about the care deficits that might have contributed to the ulcer's development, b. d. The nature and invasiveness of the surgical procedure, d. The nurse has already considered alternatives to restraints, 89. A nurse in a clinic is caring for a client who reports pain, crepitus, and a popping sound is his temporomandibular joint. Perform catheterization when you recognize the urge to void Following the teaching, the nurse asks the client to describe one physical effect. Incorrect: What seems to be going on with this client? A client who is disoriented and awaiting transfer to a long-term care facility. A nurse receives a client care assignment from the charge nurse that he believes is unfair. 4. They are more direct when discussing issues Which of the following sites should the nurse plan to use to obtain the blood specimen? a. d. Reduced blood viscosity, a. Auscultating heart sounds To focus on effective learning with this client, which of the following interventions should the nurse use? This is a task that can be delegated to the LPN/LVN. Incorrect: Here, you have a client who needs teaching about intravenous pain management using a patient-controlled analgesia (PCA) pump. One important aspect is encouraging the flow of ideas between management and staff members. a. Auscultate breath should at least ever 2 hr These individuals are selected by the charge nurse, and do not have to be nurses. A nurse removes an indwelling urinary catheter that an older client has had in place for 2 days. 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. Which of the following interventions should the nurse use to help maintain the integrity of the client's skin? 1. This individual should be provided appropriate comments of appreciation for this accomplishment. Which of the following manifestations should the nurse identify as an indication for discontinuing the application due to a systemic response? b. 1. 2. Incorrect: The RN is responsible for assessment and evaluation of clients. 4. Alcoholic Anonymous Anyone over age 18 can have an Advanced directive. Prior to shift report, the charge nurse is making assignments for the nurses on the shift. In which harmonic number n is the string vibrating? Solved 77. The nurse in a long-term care facility is making - Chegg 4. b. 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. d. Discussing intake and output - Assisting a client to ambulate using a gait belt. Point out inconsistences in the client's behavior The nurse is using which level of communication at this time? d. Transporting a cerebrospinal fluid specimen to the lab 2. d. Remove tea and coffee from meal trays, b. The client is considered unstable until assessed by the nurse. A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding herself using adaptive devices. A list of current medications is sent to the facility. Encourage clients and families to develop mutually appropriate visitation times. The client post PEG placement is stable. Tenderness over the symphysis pubis b. Which of the following info should the nurse include? Speak using his usual tone of voice b. It can develop suddenly or slowly and tends to worsen with time, unless the cause is found and treated. butter, which contain 16 g of protein, 7 g of carbohydrates, A nurse is planning care for a female client who has an indwelling urinary catheter. c. I'll clean the inside of the container with a wipe A charge nurse is planning a room assignment for a client who has a productive cough, a questionable x-ray, and a positive Mantoux test. 1. 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. a. Which of the following info should the nurse include? The second client that should be given a treatment room is the elderly client who fell and fractured the left femoral neck. Correct: The clue that should be picked up on here is that the client is now reporting that the cast has become too tight. NUR 212 Patient assignments.docx - M2.4: Making Client Care Incorrect: The RN is responsible for collecting data. a. 1. This may result in several health problems including arrhythmias, an enlarged heart, heart failure, infections and bleeding. A. nurse is caring for a client who is not cooperating with his care and demonstrates defiant behavior. 3. Injuries from a motor-vehicle accident can be life threatening. 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. Assess personal level of fatigue prior to making a decision regarding accepting or refusing assignment. There are a total of 10 adult clients. 3. Therefore, measures should be instituted to reduce the risk of the development of an overwhelming infection and sepsis. Disconnect client's nasogastric (NG) tube suction to allow ambulation. No! 3. Alcohol consumption increases the use of folates, and the alcoholic diet is usually deficient in folic acid. Which of the following health care professionals is responsible for obtaining informed consent from the client for the procedure? A lack of rapid eye movement (REM) sleep b. Select all that apply A client with fibromyalgia reporting generalized pain of 7 out of 10. c. Review a low-sodium diet for the client who has hypertension However, providing care for missing teeth would also be within the LPN scope of practice. Which of the following items should the nurse include on the lunch tray? 3. Incorrect: Although this nurse is working on the postpartum unit, did you recognize the length of experience? Correct: The nurse should recognize that this child has a very low absolute neutrophil count (ANC), which is referred to a neutropenia. Understanding the charge nurse's role in staffing Client reporting epigastric pain and nausea after eating. 4. Incorrect: A slightly decreased pedal pulse to the affected extremity is not unusual following cardiac catheterization. Incorrect: The nurse may trust the UAP; however, the nurse has not been able to determine the competency of the new staff member. A nurse is teaching a client who has strained her back muscles while preparing to move to a new apartment.
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