Managing and coordinating care
A client with a history of alcohol abuse was admitted with bleeding esophageal varices. After several days of treatment, the client is ready for discharge. The nurse enters the client's room to review discharge instructions with the client when the client tells the nurse that they want to help to quit drinking. How should the nurse respond?
"I'll notify your physician and call the social worker so they can discuss treatment options with you."
At the last hospital unit meeting, the policy for the insertion of Foley catheters was revised based on current evidence. The new nurse on the unit just learned "the old way" and is frustrated to now have to learn a new methodology. Several other nurses comment that the change is "all about money." The charge nurse must educate the staff about the importance of this new policy. Which explanation by the charge nurse is most appropriate?
"Incorporating evidence-based practice into our care routines links out interventions to valued outcomes, thereby increasing quality care. When we provide quality care, we can decrease cost."
The emergency department (ED) nurse should assess which client first?
A 40-year-old who was involved in a motorcycle accident and is now stating abdominal pain
The nurse is caring for an 8-year-old client who has cystic fibrosis. What aspects of client care should the nurse prioritize?
Airway clearance
A medical student is working with a 61 year old male client in the hospital who has presented with a new onset of atrial fibrillation. Which course of treatment will the student most likely expect the attending physician to initiate?
Anticoagulants and beta-blockers to control rate
A 78-year-old client is undergoing surgery to repair a right hip fracture. What nursing action is appropriate during the intraoperative phase?
Appropriately position the client using adequate padding and support
When caring for a client with hyperkalemia, the nurse prioritizes assessment of which body system?
Cadriovascular
Which of the following outcomes would be most appropriate to include in the plan of care for a client diagnosed with a muscular dystrophy?
Client participated in activities of daily living using adaptive devices
The nurse prepares to apply ECG electrodes to a male client who requires continuous cardiac monitoring. Which action should the nurse complete to optimize skin adherence and conduction of the heart's electrical current?
Clip the client's chest hair prior to applying the electrodes.
The nurse and the client are discussing some stratagies for ingesting iron to combat the client's iron deficiency anemia. Which is among the nurse's strategies?
Drink liquid iron preparations with a straw
An elderly client with primary degenerative dementia is slow in following simple directions and is indecisive selecting clothes to be work for the day. What is the best approach for the nurse to take?
Give the client the opportunity to select from two outfits and cue follow-through instructions
What diagnostic test does the nurse explain to the client will assist with the diagnosis of disseminated histoplasmosis?
Histoplasma urine antigen assay
When approaching health care holistically, which of the following would the nurse do?
Include physical, emotional and social elements
Which of the following is the most effective treatment for trichomoniasis?
Metronidazole (Flagyl)
A client who is 34 weeks pregnant is experiencing bleeding caused by placenta previa. The fetal heart sounds are normal and the client is not in labor. Which intervention should the nurse preform?
Monitor the amount of blood loss
A client was admitted 3 days ago and is developing signs and symptoms of pneumonia. Select the correct documentation of the diagnosis
Nosocomial pneumonia
A nurse is monitoring a client who appears to be hallucinating. The client is gesturing at a figure on the television and appears agitated with speech containing paranoid content. Which nursing interventions are appropriate at this time? select all that apply.
Reassure the client that there is no danger Acknowledge the presence of hallucinations Give simple commands in a calm voice
The nurse is working on a pediatrics unit. Which intervention for a 6-year-old who still wets the bed would be best assigned to the unlicensed personnel (UAP)?
Reminding the child to use the bathroom before going to bed
A nurse is writing plan of care for a client with a rare condition. The nurse has little experience with the condition. What action by the nurse will result in the best plan of care?
Seek research about the disorder
Which techniques is a type of cognitive behavioral therapy implemented for bulimic clients?
Self-monitoring
During which phase of the Trajectory Model of chronic illness is the focus of nursing care on reinforcing positive behaviors and offering ongoing monitoring?
Stable
The nurse conducts a home safety assessment for a client. Which statement best explains the standard of care being implemented?
The RN promotes a safe environment
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is ventilator dependent and living in Georgia, where it is frequently hot and humid. Attempts to completely wean the client at home. What should lead the nurse to determine that this is contradicted? Select all that apply.
The client's spouse wants to be the sole caretaker There is no air conditioning in the client's home
A nurse practitioner is explaining the current methods of detection of HIV to a community group. In explaining the definitive method of detection, which statement is most accurate?
The most sensitive and specific test is the western blot analysis
While receiving phototherapy, a neonate begins to have frequent, loose, watery green stools and is very irritable. The nurse interprets this as which situation?
This is a normal adverse effect of phototherapy
Why are antacids administered regularly, rather than as needed, in peptic ulcer disease?
To keep gastric pH at 3.0 to 3.5
Thalassemia can be classed as major or minor. If therapy for thalassemia major is not started in infants who present with this disease, severe growth retardation will occur. At 6 months of age which therapy must be started?
Transfusion
Children feel pain just as much as adults do. What is the major principle in pain management in the pediatric population?
Treat on individual basis and match analgesic agent with cause and level of apin
the nurse reviewing the health records for several children at a health clinic. Which would the nurse expect to be newly diagnosed with an inborn error in metabolism?
a newborn female
A client at term arrives in the labor unit experiencing contractions every 4 minutes. After a brief assessment, she's admitted and an electric fetal monitor is applied. Which finding should most concern the nurse?
blood pressure 146/90 mmHg
The nurse and an adolescent are reviewing the adolescent's record of her headaches and activities surrounding them. What activity would the nurse identify as possible trigger?
drinking three cans of diet cola
the nurse is caring for a child who had stem cell transplant and is being monitored for engraftment. Which nursing action is priority?
ensure neutropenic precautions are in place
A prenatal ultrasound reveals that a pregnant client has vasa previa. Which action by the nurse is appropriate?
explain to the client about the need for a scheduled cesarean birth
A client receives an epidural block for pain relief during labor. Which interventions by the nurse are important when caring for a client with an epidural block? Select all that apply
make sure oxygen is available monitor vital signs frequently maintain fetal heart rate and contradictions closely.
A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?
nothing by mouth
A client has exposed her desire to give birth with minimal intervention. She is now moving into active phase of labor. What intervention by the nurse would be the priority of care?
offering support by reviewing the short-pan form of breathing
the nurse is caring for a 34 year old woman undergoing for large endometrial lesions. What interventions should the nurse anticipate providing the client?
providing pain control; preparing the client for a laparoscopic procedure or hysterectomy
What position should the nurse use for the client with venous insufficiency to enhance blood supply?
supine with lower extremities elevated
The nurse is caring for a neonate with an exstrophy of the bladder. When the nurse is planning care, which client goal is the priority?
the neonate will be free from infection
A nurse caring for a client with respiratory condition notices the client's breathing pattern is getting more irregular and the rate has greatly increased form 18 to 32 breaths per minute. The nurse notes that this client's vital signs are assessed once every shift, but believes the assessment should be done more frequently. Who is responsible for increasing the frequency of this client's assessment?
the nurse
Based on the nurse's knowledge of non adherence to therapeutic regimens, which nurse needs to place extra emphasis on adherence to the treatment plan?
the nurse planning to teach adults aged 65 about congestive heart failure management
A number of clients ona geriatric subacute medical floor of a hospital have developed foul-smelling diarrhea over the least several days, and subsequent culture of stool samples has confirmed the presence of Clostridium difficile in each case. The care team on the unit would recognize that which factor likely contributed to the health problem and would anticipate which treatment?
the use of broad spectrum antibiotics likely played a role in the developments of the infections, and most clients would likely receive metronidazole as a treatment
The nurse is administering a medically fragile child. When planning care for the child and the family, what is the priority for the nurse?
to develop a trusting relationship with the family
When developing a plan of care for a patient with impaired physical mobility who must remain on complete bed rest, which of the following would the nurse most likely include to prevent external rotation of the hip?
trochanter roll
During which phase of the nurse-client relationship does the client identify and explore specific problems?
working
