Comp C pt. 2
Teach parenting skills to families at risk for abuse
A community health nurse is planning primary prevention activities to reduce the occurrence of abuse. Which of the following strategies should the nurse include in the plan?
Clarify the source of the referral
A community health nurse receives a referral for a family home visit. Which of the following tasks should the nurse perform first?
Apply continuous pressure 2.5 cm (1 in) above the percutaneous skin site.
A nurse I caring for a school-age child who is 2 hr postoperative following a cardiac catheterization. The nurse observes blood on the child's dressing. Which of the following actions should the nurse take?
Tape stockinet over monitoring device and cords
A nurse in a surgical suite is planning care for a client who requires surgery and has a latex sensitivity. Which of the following is appropriate for this client?
Hyponatremia
A nurse is assessing a client who had heart failure is taking furosemide. Which of the following findings should the nurse monitor ?
Palpate the client's fundus
A nurse is assessing a client who is 2 hrs postpartum for uterine atony. Which of the following action should the nurse take?
Weak femoral pulses
A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?
initiate a consultation with a speech
a home health nurse is caring for an adult client who reports, "I keep coughing when I try to swallow my food, but not at other times." Which of the following actions should the nurse take?
Offer high-calorie, high protein snacks to the client
nurse is caring for a client who has depression and is experiencing loss of appetite. Which of the following actions should the nurse take?
Placing a transcutaneous electrical nerve stimulation (TENS) unit on a client's abdomen
nurse is orienting a newly licensed nurse while caring for clients who are in labor. Which of the following pain management strategies by the newly licensed nurse requires intervention?
Blood pressure
nurse is planning to administer Atenolol to a client. Which of the following should the nurse assess prior to administering the medication?
Client might feel guilt over some aspect of their loss
A CN (charge nurse) is providing teaching for group of newly licensed nurse about grieving process. Which of the following information should the CN include in the teaching?
Bounding pulse
A nurse is assessing a newborn who has patent ductus arteriosus. Which of the following findings should the nurse except?
Request non gas forming foods from the dietary department
A nurse is caring for a client who has COPD and is 5kg (11lb) below her ideal body weight. The client experiences shortness of breath when eating. Which of the following actions should the nurse take?
Urinary retention
A nurse is caring for a client who has major depressive disorder and a new prescription for amitriptyline. The nurse should monitor for which of the following adverse effects?
HbA1c 6.5%
A nurse is caring for a client who is insulin dependent and is undergoing tests to determine if his blood glucose is being adequately controlled. The nurse should identify that which of the following laboratory values is the best indicator of adequate blood glucose control?
Instruct the client on the use of esophageal speech
A nurse is caring for a client who reports xerostomia following radiation therapy to the mandible. Which of the following is an appropriate action by the nurse?
The client has a history of asthma
A nurse is caring for a client who states he recently purchased lavender oil to use when he gets the flu. The nurse should recognize which of the following findings as a potential contraindication for using lavender?
Use an albuterol inhaler
A nurse is caring for an adolescent client who has cystic fibrosis. Which of the following actions should the nurse instruct the client to take prior to initiating postural drainage?
Hematuria
A nurse is caring for an infant who has gastroenteritis. Which of the following assessments should the nurse report to the provider?
New prescription for an iron supplement
A nurse is obtaining a nutritional health hx on a client who reports problems with constipation. Which of the following should the nurse identify as a cause of constipation?
Dysphagia
A nurse is providing care for a client who has esophageal cancer and has received radiation therapy. Which of the following finding should the nurse identify as the priority?
Avoid hot tub while wearing the patch
A nurse is providing discharge teaching to a client who has cancer and a prescription for a fentanyl 25 mcg /hr transdermal patch. Which of the following instructions should the nurse include in the teaching?
I can resume activities, such as sewing
A nurse is providing discharge teaching to a client who is postoperative following the surgical repair of a detached retina. Which of the following statements by the client indicates an understanding of the teaching?
Sensation of skin warmth
A nurse is providing teaching to a client who is to undergo a cardiac catheterization. Which of the following findings is expected during the procedure?
"You should not have this procedure if you are allergic to iodine."
A nurse is providing teaching to a client who will undergo a magnetic resonance imaging (MRI) scan. Which of the following statements is appropriate to include in the teaching?
"I will avoid food and beverages that contain caffeine"
A nurse is providing teaching to an adolescent who has peptic ulcer disease. Which of the following statements by the client indicates an understanding of the teaching?
Place a cardiac monitor on the client
A nurse is reviewing the laboratory findings of a client who is receiving IV infusion of insulin. The client's lab findings reveal a potassium level of 5.5 mEq/L, BUN of 15 mg/dL, and a creatinine level of 1 mg/dL. Which of the following interventions is appropriate for the nurse to take?
Peripheral neuropathy
A nurse is reviewing the medical record of a client who has a prescription for intermittent heat therapy for a foot injury. Which if the following findings should the nurse identify as a contraindication for heat therapy?
A client who is taking warfarin and has INR of 1.8
A nurse is reviewing the medical records of four clients. The nurse should identify that which of the following client findings follow up care?