PrepU Manging Care
A client is admitted with a diagnosis of viral gastroenteritis. The client has an elevated blood urea nitrogen and creatinine and is oliguric with a blood pressure of 74/30 mmHg. Which order from the healthcare provider should the nurse carry out first? Administer an antiemetic. Collect stool samples. Administer an antipyretic. Administer intravenous fluids.
Administer intravenous fluids.
Discharge plans for a client with a mental health disorder include living with family members. The nurse learns that the family is no longer willing to allow the client to live with them. What is the nurse's most appropriate action? Instruct the client to make alternate living arrangements. Communicate with the physician about additional orders. Collaborate with other disciplines to revise the discharge plans. Inform the family that it is not possible to change the discharge plans
Collaborate with other disciplines to revise the discharge plans.
The nurse is admitting a 12-year-old child diagnosed with osteomyelitis of the left femur. What will be the nurse's first action for the child's care? Draw blood for cultures as ordered. Prepare the child for immediate surgery. Administer intravenous antibiotics as ordered. Monitor hepatic and renal studies
Draw blood for cultures as ordered.
The goals of health care reform include which? Decreasing health care services to provide all citizens with some access to care but control escalating costs Focusing on cost containment with improved access and quality of services for everyone Controlling health care costs by providing limited services for more consumers of health care Improving quality of care while limiting access for the uninsured to control rising costs
Focusing on cost containment with improved access and quality of services for everyone
A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis? Ischemic stroke Encephalitis Subarachnoid hemorrhage Status epilepticus
Ischemic stroke
The nurse is caring for a client with a nursing diagnosis of deficient fluid volume. The nurse has implemented the plan of care and on evaluation finds that the client continues to exhibit symptoms of deficient fluid volume. What should the nurse do next? Modify the plan of care and interventions to meet the client's needs. Change the nursing diagnosis because the client's problem was falsely identified. Develop an additional nursing diagnosis to meet the client's health needs. Reassess the client for more symptoms of deficient fluid volume.
Modify the plan of care and interventions to meet the client's needs.
Which therapeutic exercise is done by the nurse without assistance from the client? Resistive Active Isometric Passive
Passive
The client explains to her new provider that she receives periodic phlebotomies to decrease her red blood cell mass. The provider believes the client may have: Megaloblastic anemia Polycythemia vera Beta-thalassemia Sickle cell disease
Polycythemia vera
A nurse is caring for a child with Wilms tumor, stage I. Which statements are true regarding this diagnosis? Select all that apply. Prognosis is good with treatment. The tumor is limited to the kidney and can be excised with the capsular surface intact. Prognosis is poor even with treatment. The tumor has undergone hematogenous metastasis, most commonly involving the lung.
Prognosis is good with treatment. The tumor is limited to the kidney and can be excised with the capsular surface intact.
"The client will demonstrate cast care prior to discharge" is which type of evaluative statement? Physical changes Affective Psychomotor Cognitive
Psychomotor
A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be: Catheterization and increased fluids to increase vascular flow Psychosexual counseling and PDE-5 inhibitor medications Intravenous administration of a PDE-5 inhibitor Surgical placement of a penile prosthesis
Psychosexual counseling and PDE-5 inhibitor medications
When caring for a family who is coping with a crisis illness situation, which family function would the nurse identify as being most crucial? Boundary setting Management Communication Support
Support
A client is admitted to a hospital unit with scleroderma. The nurse is unfamiliar with this condition. What is the nurse's best source of information about this condition? The nursing and medical literature The client The client's physician The client's chart
The nursing and medical literature
The nurse is preparing a hospitalized child for a lumbar puncture. The health care provider states the procedure will be performed in the child's hospital room. To advocate for the child, what should the nurse inform the health care provider? "I will have the procedure prepared in the treatment room, so that the child may view the hospital room as safe and secure." "We will have to have the parents hold the child down because there is not enough assistance on the floor." "The parents want to be present during the procedure, and I informed them that this is not the policy of our facility." "I will prepare the hospital room for the child, because that room is where the child will feel most comfortable."
"I will have the procedure prepared in the treatment room, so that the child may view the hospital room as safe and secure."
The nurse is caring for a client who had a cerebrovascular accident (CVA) and needs to be fed. What instruction would the RN give the unlicensed assistive personnel (UAP), who will feed the client? "Position the client in a sitting position before feeding." "Check the client's gag and swallow reflexes." "Feed the client quickly, there are four more client's to feed." "Suction the client's secretions between bites of food."
"Position the client in a sitting position before feeding."
A client with schizophrenia repeatedly uses profanity during an activity therapy session. Which response by the nurse is appropriate? "Your behavior won't be tolerated. Go to your room immediately." "Your cursing is interrupting the activity. Take time out in your room for 10 minutes." "I'm disappointed in you. You can't control yourself for even a few minutes." "You're just doing this to get back at me for making you come to therapy."
"Your cursing is interrupting the activity. Take time out in your room for 10 minutes."
The school nurse informs the mother of a second-grade student that lice were found in the child's hair. The mother explains to the nurse that she has another child to pick up and cannot stay to receive education related to the treatment of lice at this time. The mother reassures the nurse that she will "look up treatment options on the Internet and take care of the child." What would be the best action of the school nurse in this situation? Instruct the mother to treat the other child for lice in the same manner as the second-grade child Perform hand hygiene and notify the second-grade teacher to wash down the classroom Notify the social worker of suspected child neglect and make a referral to child protective services Provide the mother with a list of credible websites related to the treatment of lice
Provide the mother with a list of credible websites related to the treatment of lice
A client with hepatitis B is visiting with a sibling when the client's I.V. catheter dislodges and bleeds onto the surface of the bedside table. Which action, if observed, would cause the nurse to intervene? The sibling of the client is asked to move away from the area. The client holds pressure using a sterile 2 x 2 gauze. The housekeeper uses a bleach solution to clean the table. The nursing assistant uses tissue to blot up the blood.
The nursing assistant uses tissue to blot up the blood.
A client has been diagnosed with posttraumatic stress disorder (PTSD) after witnessing an explosion at the client's industrial worksite. The client will soon begin exposure therapy, so the nurse should prepare the client for: a family meeting where each member will describe the effects of the client's PTSD. a visit to a support group created for victims of the tragedy. a critical examination of the ways the client's PTSD has affected the client's life. a visit with the therapist to the place where the explosion occurred.
a visit with the therapist to the place where the explosion occurred.
A clinical nurse specialist developed clinical pathways for common orthopedic conditions. In which way should the interdisciplinary team use these pathways? as guidelines to ensure continuity of care as a way to accurately document care as a staff education tool about optimal care as a step-by-step care plan for clients
as guidelines to ensure continuity of care
The most important responsibility of the nurse is to prioritize and ensure that routine nursing measures on non-critical clients are assigned. The nurse is performing which functions? networking delegation advocacy clinical coordination
delegation
A continuing education nurse in a long-term care facility is discussing wound healing in older adult clients. Because older adult clients are more likely to have comorbidities like problems with mobility, diabetes, or vascular problems, the nurse should assess the clients for which condition(s)? Select all that apply. impaired healing related to diabetes skinned knees from bumping into doors ischemic ulcer formation in feet pressure injuries on buttocks facial lacerations related to shaving
impaired healing related to diabetes ischemic ulcer formation in feet pressure injuries on buttocks
A nurse is developing a care plan for a client recovering from a serious thermal burn. What does the nurse determine is the priority goal of therapy? providing adequate management of pain maintaining the client's fluid and electrolyte balance maintaining a caloric intake to meet metabolic needs providing emotional support to the client and family
maintaining the client's fluid and electrolyte balance
The nurse is caring for an adult paraplegic with an ostomy. Which is an appropriate statement for the nurse to make? "What type of pouching system do you use, honey?" "Who changes your pouching system at home?" "I insist that I empty your ostomy pouch now." "Do you need assistance managing your ostomy?"
"Do you need assistance managing your ostomy?"
A client who was bitten by a wild animal is admitted to an acute care facility for treatment of rabies. Which type of isolation does this client require? contact respiratory strict enteric
contact
The nurse is preparing the client newly diagnosed with peripheral arterial disease for discharge with the medication atorvastatin. What laboratory work should the nurse obtain to establish a baseline before starting the medication? white blood cell count and blood sugar creatinine level and liver function tests platelet count and urinalysis hemoglobin and hematocrit levels
creatinine level and liver function tests
A client has approached a nurse for advice on how to deal with the client's alcohol addiction. The nurse should tell the client that the best initial treatment is: abstaining from alcohol. aversion therapy. Alcoholics Anonymous (AA). psychotherapy.
abstaining from alcohol.
Based on the Patient Protection and Affordable Care Act (ACA), nurses are to assume an important new role in health care. Which is an example of this new role? Verifying that all documentation is updated prior to surgery Collaborating with all agencies to provide for the client's home health needs Providing client education related to colostomy care Identifying individuals who are at risk of developing diabetes mellitus
Collaborating with all agencies to provide for the client's home health needs