3. b. -Review a low-sodium diet for a client who has HTN A client requesting assistance packing his belongings for discharge later today.. d. 216, 22. Incorrect: The client does need to be cleaned out below the tumor so that the primary care provider can see the area of concern and complete the biopsy. Electric comes from the Latin word for amber, a substance which readily takes a static electric charge. a. I will be able to tell how much oxygen I'm getting by looking at the flowmeter d. Complete an incident report, 70. d. Remove tea and coffee from meal trays, b. a. Correct: Did you notice the hint? 2. Explain administration is demanding a decreased overtime. After the provider determines no medical cause for the client's incontinence, which of the following interventions should the nurse initiate to manage this behavior? a. Incorrect. The client then states, "I have changed my mind and do not want to have the procedure done." c. Holds the soiled linen against her body while carrying it to the linen bag 4. d. Custard 1. Which of the following actions should the nurse perform when opening the sterile pack? Ask the primary healthcare provider to suggest the best oral care procedure. A newly hired unlicensed assistive personnel (UAP) has consistently completed all assignments in a safe and timely manner. This may result in several health problems including arrhythmias, an enlarged heart, heart failure, infections and bleeding. 2. A nurse is using the communication principle of presence when establishing a collaborative relationship with a client. A nurse is planning care for a female client who has an indwelling urinary catheter. 1. a. I will begin 48 hr before the client's discharge d. Have the client practice blood-glucose monitoring using a glucometer, d. When asking if the client took his medications this morning, 81. Autonomy vs shame and doubt A client requesting assistance packing his belongings for discharge later today., Incorrect: The client does need to have food; however, there is another action that should be performed first. 3. 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. A client on a surgical unit frequently quarrels with the staff. Dexlansoprazole 30 mg PO daily. Feed a client that had a stroke 3 months ago. *HURST REVIEW Qbank/Customize Quiz - Leadership 3. Asking for an explanation Correct: The client may be experiencing a myocardial infarction and requires further assessment. There may be a good reason that the tray was not served. 1. This client is eating a simple carb snack, but the nurse needs to check the client's blood glucose level to see if the snack has helped. 1. 3. Place the client in a lateral position b. I'm so sorry to hear about this Turning off continuous tube feeding to reposition a client, then turning the feeding back on. Incorrect: The concern here is the client being fed their meal. Incorrect: This would unnecessarily alarm the clients. Prior to shift report, the charge nurse is making assignments for the nurses on the shift. 1. This referral would be appropriate. A written report of the incident is completed by the nurse and turned into the appropriate person (generally the performance improvement department). Each state BON differs in that also some have treatment programs they administer themselves. What would the approximate meaning of photoelectric be, based on these root words? Which of the following actions by the nurse is considered an indirect nursing care activity? assignmentcafe.com - A charge nurse is making assignments for nursing Incorrect: This is doing research, which requires the research process be implemented, including appropriate approval. a.) 1. A nurse in a clinic is caring for a client who reports pain, crepitus, and a popping sound is his temporomandibular joint. a. 3. Client who requires teaching about the use of a patient-controlled analgesia (PCA) pump. Drag and Drop the items from one box to the other. d. Do you think crying will help? 1. A client with atrial fibrillation currently on a diltiazem drip. 3. c. Lock the medication in a room and finish preparing it after returning from the emergency 76. c. Measurement of residual urine after urination b. Determine caregiver's stress level and coping strategies. a. Respite care allows the primary caregiver time away from day-to-day care responsibilities & 5. The client was lying on the floor next to his bed 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. Show client who has conjunctivitis how to clean the eyes. Cardiac catheterization with a decreased pedal pulse below insertion site. 3. 2. b. and 16 g of fat. Monitor client for pain while assisting with ambulation. Notify the nursing supervisor of the situation. Take several shallow breaths during the procedure b. I will try to anticipate and avoid stressful situations when possible Elderly client admitted 30 minutes ago with reports of constipation for four days. 4. The infusion rate has stopped but the tubing is not kinked Convenience for the nursing staff or the client's family d. Left forearm, b. 5. Correct: The nurse has not been able to determine the skill of vital sign assessment for this new UAP. 3. The nurse should do this when repositioning is needed. 2. b. c. Malpractice Did you recognize ureterolithiasis as "kidney stones"? Incorrect: Hanging a new bag of TPN is parenteral therapy requiring a central line. a. Select all that apply. Covering open wounds will help to decrease bacterial exposure until the registered nurse or primary healthcare provider can assess and treat each wound. The option does not say the client is terminal, in a vegetative state, or in a coma. A charge nurse is reviewing the list of tasks that have been delegated to the assistive personnel (AP) by the staff nurse. INCORRECT: There is no information regarding how recent was the surgery or the degree of pain being experienced. 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. Talk with the client's partner, b. Focusing a. This action will promote the client's self-esteem, and may reduce the quarrelsome behavior. A Charge Nurse Role: The Ultimate Guide. c. Use an aggressive tone of voice They are able to manage tasks related to basic care. What interventions can the nurse delegate to the LPN/VN? 4. 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. Refuse the overtime assignment, being prepared for disciplinary action. b. I will call the doctor and get the prescription 2. Airborne A client post pacemaker insertion, awaiting discharge instructions. Correct: The nurse should recognize that this child has a very low absolute neutrophil count (ANC), which is referred to a neutropenia. d. Wait to discuss the behavior in the presence of others, a. 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. The nurse assists the patient to the bedside commode and the client sustains an injury to the operative area. 2. Give magnesium citrate 296 mL at 3 PM today. Based on a concept analysis of the charge nurse role, the author looks at a theory-gap analysis regarding how patient a All these clients have a GI problem. c. Check to see if the suction equipment is working c. Behaving defensively b. 1., 2., 4., & 5. But the client does need to be assessed prior to the client with Crohn's disease who is improving. a. Client who has multiple injuries from a motor vehicle accident. c. imaginary 2. c. Make sure the client has an intake of 2,000-3,000 mL of fluid/day The area surrounding the insertion site feels warm to the touch A nurse identifies a pressure ulcer after a client had a long, extensive recovery following a surgical procedure. _____The house that we lived in for nine years has been sold. b. The Role of the Registered Nurse as Charge Nurse Talk to each nurse about concerns related to assigned clients. Which of the following tasks should the nurse delegate to AP? Nursing Brain Sheet 4 Patients - luoe.expertoendermatologia.es The nurse did not trust the new UAP. Report of feeling pressure 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. d. They disclose more personal information, a. Explore the client's feelings c. I'll clean the inside of the container with a wipe Correct: Clients diagnoses with folic acid anemia typically have developed the anemia from chronic alcohol abuse. Which of the following actions should the nurse take? Turn on local news for up-to-date information on the train derailment. Incorrect: Emergency room nurses deal with life threatening emergencies but are not specialized in the care of clients with preeclampsia. If you are new to this challenge, try these eight tips as a guide for making nurse-patient assignments. A nurse instructs a female client about collecting a midstream urine sample. b. The second client that should be given a treatment room is the elderly client who fell and fractured the left femoral neck. The charge nurse is responsible for ensuring that the patients on the unit are properly cared for in a safe and efficient manner. The nurse should assess the client for which of the following expected outcomes after catheter removal? Well, many diabetics experience diabetic neuropathy and it is not a situation that makes this client unstable or critical. d. I have a set of my brothers' crutches in the basement I can also use, a. }? benefactor of the world. Because facilities generally prefer some type of consistent schedule for staffing purposes, older visitation policies were often very restrictive. Which action by an unlicensed nursing assistant would require the nurse to intervene? Ask the float nurse, "Have you been drinking?" Correct: This group of clients is primarily med surgical. This client is stable and predictable. c. Offering false reassurance Client #5 -It is considered within the scope of practice for an LPN/LVN to monitor a transfusion of a blood product. Incorrect: A client who has a spinal cord injury and is in rehabilitation is still alert and able to make decisions. Serve food that have a hot/cold balance There are potential problems in Options #1, 2, 3, and 4 and should be questioned and corrected. Notify the board of nursing (BON) that the float nurse is an alcoholic. 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. 3. c. Hallucinations at the onset of sleep, 65. This is not a situation that requires the LPN to notify the primary healthcare provider. The nursing supervisor may be able to assist with client care until another nurse can come in to work. 1., 2., 4., & 5. The abdominal pain is worsening. Complete blockage of the large intestine. A nurse is administering a cold therapy application to a client. Provides day to day direction and supervision to assigned direct patient care staff. The LPN/LVN can gather data, but the RN is responsible for validating and interpreting that data to assess and evaluate. e. Dysuria, 49. They have found my address and are coming for my family!" 2. Encourage the client to use self-exploration Which actions should be instituted by each unit's charge nurse? 4. NUR 212 Patient assignments.docx - M2.4: Making Client Care e. Feed a client who had a stroke 3 months ago, 31. c. I will complete the smoking cessation program I started Take vital signs every two hours for the patient with the cholecystectomy in Room 6022. The client is reporting anxiety, discomfort, and a feeling of bloating. PURPOSE AND SCOPE: Supports FMCNA's mission,vision, core values and customer service philosophy. b. Correct: The client has the right to be involved in the decision making of their care. Correct: The LPN is being floated to a specialty floor and appropriate assignments would include clients who are stable. Which task would be appropriate for the nurse to assign to an LPN/VN? 1. Alcohol consumption increases the use of folates, and the alcoholic diet is usually deficient in folic acid. A nurse asks a client to share personal stories. The crying toddler has missing front teeth, but there is no indication this was the result of the hurricane. Besides yourself, there are the following staff: Your unit has 12 beds. Therefore, the nurse with the labor and delivery experience would be more appropriate to assign to this client. The nurse voices his concern to the charge nurse. Notify the surgeon that the client wishes to withdraw informed consent for the procedure (the client has the right to withdraw consent therefore the surgeon should be the one notified of the request), 14. A nurse is teaching a client about the physical effects of chemotherapy. Remember, pick the killer answer first! a. I'll urinate a little then stop A nurse is assessing a client at a follow-up clinic for acute low back pain. This center functions as 'information central', where all plans or activities are coordinated and determined by those personnel. Report the incident to the charge nurse IV of D5 NS at 75 mL/hour with a 20 gauge catheter. There are a total of 10 adult clients. Some general guidelines are necessary, with input from clients and family to individualize any special requests with assistance from the facility. 2. The nurse asks the client, "Are you feeling anxious about the results of your colonoscopy?" The best practice committee works to improve clinical practice based on current research. Risperidone .5 mg PO daily 4. A client who is disoriented and awaiting transfer to a long-term care facility. Incorrect: Aplastic anemia is a blood disorder in which the body's bone marrow doesn't make enough new blood cells. Call the family of a client suffering from dementia to discuss long term care placement. Check environment for potential safety hazards. Providing a passive response 4. This perceived lack of control can create distrust and frustration among personnel, ultimately impacting client care. c. Shivering b. a. Incorrect: It is important to hear what the nurse is saying and not to dismiss the request by refusing to reassign the clients. A float nurse arrives on the unit to assist in the care of clients for the shift. 4. A nurse wants to find out a better way to perform oral care on unresponsive clients. The first client needing the nurse's attention is the one reporting a headache and has a fruity odor to their breath. 2. (SATA) -Bathing a client who had an amputation 2 days ago. The assignment process requires constant evaluation and reevaluation of information and priorities. c. Foot Explain oral hygiene to a client receiving chemotherapy 2. Which of the following statements should the nurse identify as an indication that the client understands the discharge information? (Sclect all that apply) A. Bathe a client who had an amputation 2 days ago. An adult (18 years or older) can create an advanced directive. b. - Assisting a client to ambulate using a gait belt. This determination is needed to assure client safety is being considered. A nurse in a dialysis center is caring for a client who has a new diagnosis of end-stage kidney disease. 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 c. Gender (Select all that apply.). 1. a. 2. A nurse is preparing an education presentation about organ donation for a group of newly licensed nurses. A nurse is teaching a client who has a history of falls about home safety. d. What have you done in the past to cope with this issue? The nurse prefers to check all vital signs on all clients. There is a possibility of rejection, which means close assessments and evaluations are needed by the RN. a. Documentation is a communication tool for the interprofessional health care team. c. Providing anticipatory guidance to a client in crisis A nurse is caring for a client who states, "I have got to get out of this hospital! Communicates with the physician and other members of the healthcare team to interpret, adjust, and complete patient care plans. 1. 3. Which of the following findings should the nurse expect? a. The nurse is using which level of communication at this time? A home health nurse is conducting a home safety assessment for an older adult client. Lisinopril 20.0 mg PO daily Correct: A long term care facility is considered a client's "home environment", and families are encouraged to visit often. A nurse is caring for a client who receives intermittent enteral feedings through an NG tube. c. The chances of a malpractice suit are minimal as long as you follow our policies and procedures When determining if the client is eating a well-balanced diet Feed the client after warming the food. c. 214 Answer the following question to test your understanding of the preceding section: A charge nurse is planning client activities for the day. Incorrect: This will take some time and would be best accomplished by sitting with the family to discuss options. c. Respite care helps relieve pain and promote comfort The report should contain consequences. 3. Learning Objectives for this assignment include: Apply the principles of delegation in the healthcare setting. INCORRECT 3) Review a low-sodium diet for a client who has hypertension. The best practice committee utilizes current research in their recommendations. a. I will wear gloves when removing food from the freezer Select all that apply The second client that needs to be seen by the nurse is the client having weakness, a sign of hypoglycemia. 4. 3. d. Identifying the client by name when making a referral for home health services, 30. b. b. a. Therefore, this client would not be a priority over a client who may be experiencing a MI. This client could be transferred with traction still maintained. Find a mentor Most nurses learn to make nurse-patient assign-ments from a colleague. 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. 1) Bathe a client who had an amputation 2 days ago. c. I suggest you talk with a mental health counselor about your concerns 3. A nurse is caring for a client who is about to have a colonoscopy. 8. Dr. Frankenstein had seen himself as a(n) ?\underline{? Complete a client assignment sheet for the oncoming staff. 2. 5. b. 4. These irregularly shaped cells can get stuck in small blood vessels, which can slow or block blood flow and oxygen to parts of the body. Incorrect: A UAP may not remove and change surgical dressings, which would involve assessment and further education. Announce the new changes at the monthly staff meeting. 3. 3. This assumption is not appropriate, and the feelings and concerns of the client should be addressed. 2. The body needs vitamin B12 to make red blood cells. This can prevent harm to client's. The other options may be correct but are not the best first action. A medical-surgical LPN has been sent to a short-staffed pediatric unit. A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding herself using adaptive devices. d. Transporting a cerebrospinal fluid specimen to the lab During exacerbation, the client will have many diarrhea stools. 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. Teaching is not in the role of the LPN and therefore, this client would need to be assigned to the RN, not the LPN, for the teaching needs of the client. c. Discard the tablet and obtain another dose of medication Which of the following tasks should the charge nurse reassign to a licensed nurse? 4. Education A nurse is performing care activities for a client in the zone of touch that requires his consent. Protective Correct: An LPN/LVN's scope of practice includes tasks such as wound care. 4. 4. 1. 1. d. Question the charge nurses about the care deficits that might have contributed to the ulcer's development, b. d. Move to the opposite side of the pack and open the fourth flap, 54. a. d. Place the tablet directly into a medication cup, 36. Assist a client to ambulate using a gait belt d. Anger, b. Total abdominal hysterectomy, bladder suspension with A&P repair, client with breast reduction. Accept the client's behavior as confrontational. However, since the new UAP's competency level is not known, the nurse does not delegate this task for the safety of the client. 1. 4. Explain to the RN that all the nurses have the same number of clients. Correct: If suspicious behavior occurs, it is important to keep careful, objective records. A Medical Power of Attorney is a type of Advance Directive that appoints a health care agent to make decisions on the client's behalf when the client is unable to do so. They are more direct when discussing issues The partner relates her concerns about her spouse abusing alcohol and having difficulty maintaining employment. Richied5864 Richied5864 . c. I will make sure my visitors smoke outside a. Allowing staff to vent is acceptable but the nurse manager should focus on constructive methods of adjustment to the impending mandated changes. What task would be appropriate for a nurse caring for a client diagnosed with gastroesophageal reflux to delegate to an unlicensed assistive personnel (UAP)? A client with a fractured right humerus who reports the cast is too tight. Which of the following actions should the nurse take to assist the client with feeding? What action should the nurse implement first to ensure client safety? 3. The charge nurse needs additional information to make a decision. D. This is the most stable of the four clients which places this client last to be seen. Confrontation should occur in the presence of a charge nurse or supervisor. The nurse can also accept the assignment; however, that nurse should document professional concern for client safety and the process you used to inform the facility (manager) of your concerns. A nurse is caring for a client whose partner asks to speak with the nurse. d. Use attentive listening with the client, d. Water heater temp 54.4 C (130 F) (no higher than 49 or 120) Client scheduled for a dressing change to foot ulcer. Two hours . Twist at the waist when she moves an object to one side 3. This service focuses on teaching the primary caregiver to meet the client's needs 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. 3. 1. The client is receiving IV fluids through an IV catheter inserted in the basilic vein on the right forearm.