Funds tests 7-16

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Which statement is inappropriate for the nurse to say prior to administering an intramuscular analgesic medication to a school-age child?

"My injections don't hurt."

While taking a shower, a patient becomes light-headed and dizzy. When reporting this occurrence to the health-care provider, which statement is accurate from the nurse?

"The patient became light-headed and dizzy in the shower due to hypotension."

The nurse reinforces education about motor vehicle safety to a young couple who is about to start a family. Which client statement indicates the need for additional teaching?

"The use of a car seat becomes optional once the child grows out of the infant stage."

A nursing instructor explains that for learning to truly take place, the information must be reinforced. A student demonstrates understanding by saying which of the following?

"I must make sure several times that the client knows what medications will be prescribed."

The nurse reinforces education for a patient with a history of orthostatic hypotension. Which patient statement indicates the need for additional teaching?

"I will remain flat in bed."

When educating a student about how to correctly logroll a patient, the nurse recognizes that additional teaching is necessary when the student makes which statement?

"I will stand at the patient's feet and control the turn."

The nurse observes a caregiver positioning a patient in the bed. Which caregiver action requires an intervention by the nurse?

Allowing a patient's arm to dangle over the side of the bed

The nurse thoughtfully plans care for an assigned client. What should the nurse do to provide culturally competent care?

Become familiar with any facet of the client's culture that may have an impact on the care.

A client reports developing nausea and vomiting the morning of having a scheduled medical examination. Which type of defense mechanism is this client most likely experiencing?

Conversion reaction

The nurse is concerned that a client is experiencing stress. Which symptom would the nurse assess in this client to make this clinical determination?

Experiencing a backache for several weeks

Which action is best from the nurse when providing care to a toddler who throws a "temper tantrum" during a well-child visit?

Removing the toddler to a quiet place away from the situation

A client being seen in the clinic reports having pain on the right side of the abdomen. In which phase of illness is this client?

Seeking help

Which may be used to treat diarrhea in infants?

Soy

The nurse reinforces education for the family of a terminally ill patient. When discussing respite care with the family, which statement by a family member indicates correct understanding of the information?

"Respite care means that I will be given an opportunity to have time away from my spouse without worrying about his care." 4 14. ones about places and based on the current information? patient.

Anurse reinforces education to a patient about how to avoid developing osteoporosis. Which patient statement indicates to the nurse a need for additional teaching?

"I will remain in bed when I have a cold."

The nurse suspects that a client is using the defense mechanism of intellectualization. Which comment did the client make for the nurse to come to this conclusion?

"I'l miss my mom, but she was in so much pain all of the time."

The nurse provides safety education to the parents of preschooler and school-age children. Which parental statement indicates to the nurse the need for additional teaching regarding the safety needs of these children?

"My child's greatest safety risk is choking at this stage of development."

The nurse reinforces education to a terminally ill patient and family regarding the senses. Which statement by a family member indicates correct understanding of the information presented?

"My loved one's ability to hear is the last sense to go at end of life."

The nurse reviews Healthy People 2020 with a client. What are the goals of this plan? Select all that apply.

Achieve health equity and eliminate disparities. Create social and physical environments that promote good health. Promote quality of life, healthy development, and healthy behaviors.

A nurse is caring for a clicnt with cancer. The client is interested in complementary treatments to help relieve chemotherapy-induced nausea and vomiting. Which would the nurse expect the health-care provider to recommend?

Acupuncture

A client seeks medical attention for a sore throat, nasal congestion, and productive cough. For which type of illness should this client receive care?

Acute

The nurse is caring for a 69-year-old client who fell and broke his wrist. The client also has open wounds on his legs from the fall. The client's health history notes he walks 30 minutes three times per week and eats a balanced diet. The client reports feeling more stressed than usual in the last few months, which has caused him to get less sleep than normal. Which factors may increase this client's risk of infection? Select all that apply.

Age Wounds on the legs Amount of sleep

A client smashes a finger in a locked car door. After several minutes, the car door can be opened, the hand is released, and blood flow returns to the digits. Which phase of the general adaptation syndrome is the client experiencing?

Alarm

The nurse is caring for a 7-year-old client. The nurse is providing education to the client about receiving vaccinations. Which is an appropriate action for the nurse to take when teaching the client?

Allow the client to model giving vaccinations on a teddy bear

The nurse provides care to a patient who begins to fall during ambulation. Which nursing action ensures safety for the nurse and the patient in this situation?

Allowing the patient to slide down the nurse's leg to the floor

A client reports skipping church because of not wanting to sce certain people who might be in attendance on a holiday. Which defense mechanism did this client use?

Avoidance

The nurse provides care to a patient who is dying of colon cancer who states, "I know I can beat this cancer I just change the things that I eat." Based on Kübler-Ross' stages of grief, which stage does the nurse document in the medical record that the patient is experiencing?

Bargaining

The nurse provides care to a patient who has died. Which action does the nurse implement when preforming postmortem care?

Bathe the patient's body and remove all tubes, unless an autopsy is prescribed.

Aclient with a terminal illness is angry with God, Which intervention should the nurse use to address this client's spiritual distress?

Be present.

The nurse provides care to a patient who is lethargic and unable to tolerate standing for long periods. The patient experiences dyspnea on exertion. Which type of bath is best for the nurse to implement with this patient?

Bed bath

The nurse provides care to a terminally ill patient. Upon entering the patient's room, the nurse notes the patient is not breathing. The patient does not have a do-not-resuscitate (DNR) prescription. Which action does the nurse implement based on the current data?

Begin cardiopulmonary resuscitation (CPR) because a DNR prescription is not written.

The nurse strives to provide culturally competent care. Which areas that influence the patient's health should the nurse understand? Select all that apply.

Behavior Perceptions Expectations Decision-making process

A client makes an appointment at the health clinic to receive an annual influenza vaccination. Which health belief is this client demonstrating?

Biomedical

When caring for a client with bilateral wrist restraints, a nurse can delegate which of the following to a certified nursing assistant (CNA)?

Checks and releases of the restraints

A nursing instructor is teaching students about bathing patients. Which are benefits of bathing? Select all that apply.

Cleanses the skin Increases sensation Promotes circulation Improves self-esteem

A health-care organization is preparing for a site visit from The Joint Commission. What should the organization about addressing client's culture?

Clients have the right to receive care that is considerate of culture, religion, and spiritual being.

Which scenario does the nurse identify as exemplifying the transition to concrete operational thought as explained by Piaget?

A child no longer believing that an adult dressed in a mouse suit is a giant mouse.

Which of the following shows the use of integrative health care?

A client controls hypertension with prescription medication, dietary changes, and by doing yoga

For which clients might acupuncture be a belpful treatment? Select all that apply.

A client experiencing vomiting after their chemotherapy treatment A client with chronic migraine headaches A client with carpal tunnel syndrome A client with lower back pain

An intervention on tbe part of a nursing instructor would be required in which situation?

A student ties the lower strings of a mask up on the head.

Which positioning device does the nurse place to prevent the patient from experiencing an external rotation of the legs?

A trochanter roll

The nurse is caring for a client who is being treated for chronic back pain. In addition to prescription pain medication, the client also sees a chiropractor several times a month. In this case, seeing a chiropractor would be considered which of the following?

Complementary therapy

A patient lies in a special type of bed frame that allows the entire bed to turn from side to side. The mattress low air-loss and the bed can be programmed to turn by degrees at set intervals. Which term does the nurse use when documenting information about this bed in the patient's medical record?

Continuous lateral-rotation bed

The nurse provides care for a patient who has been on prolonged bedrest and is now experiencing shortening and tightening of the muscles due to disuse. The nurse includes interventions in the plan of care to address which condition?

Contractures

Before creating a plan of care, the nurse assesses a client's rituals, values, customs, and beliefs. What is the nurse assessing?

Culture

A client seeks a vigorous, strenuous massage with focused pressure applied to tightened muscle areas and trigger points. This type of massage is called

Deep tissue

A nurse is caring for a client who is newly diagnosed with type 2 diabetes mellitus. The client requires teaching about antidiabetic medications, including when to take them, what effects are expected, and negative side effects to report if they occur. Which nursing diagnosis does the LPN/LVN expect to be used for this client?

Deficient knowledge.

A nurse delegates early-morning care to a certified nursing assistant (CNA). Which observation necessitates intervention by the nurse?

Dimming the lights

The nurse prepares to perform postmortem care on a patient who passed away. Which step does the nurse implement for safety during this procedure?

Donning gloves

A homeless client reports having foot pain for several months, but is just now seeking medical attention because he did not have access to health insurance. For which reason has this client delayed seeking care?

Economics

The nurse plans care for hospitalized patients. When planning care for this patient, the nurse includes intervention to prevent which preventable condition that is responsible for the most preventable deaths during hospitalization?

Embolism

The nurse provides care to a terminally ill patient who has barely eaten anything for several days. Which nursing action is appropriate for this patient?

Encourage the patient to eat whatever foods he or she thinks sound and look appealing.

A nurse is caring for a female client who has been hospitalized for a right-sided cerebrovascular accident (CVA). The client is impulsive and confused. She has weakness on the left side of her body and requires assistance when ambulating. What is the nurse's highest priority when caring for this client?

Ensuring that the bed alarm is turned on

A young adult brags to a nurse stating, "I never get sick and have not needed to see a doctor in years." Which frequency does the nurse recommend for the client to receive physical examinations and screenings even when feeling healthy?

Every year

A client with arthritis complains of increased pain and stiffness in cold damp weather. Which term should the nurse use to explain the client's symptoms?

Exacerbation

A client is experiencing spiritual distress. Which should the nurse expect to assess in the client? Select all that apply.

Exhibits feelings of hopelessness Shows signs of depression Exhibits anger at God

A client from a non-English speaking culture becomes visibly upset when the phlebotomist arrives to draw a blood sample, and he changes clothes to leave the hospital. What should the nurse do at this time?

Find an interpreter to help with communication.

The nurse plans to reinforce education for an adolescent client. Which topics does the nurse include during the session? Select all that apply.

Firearms Birth control Internet safety Sexually transmitted infections

The nurse provides care for a patient after a lumbar puncture. Which position does the nurse place the bed for this patient?

Flat

The nurse provides care to a patient whose proper flexion of the ankle is lost, and permanent plantar flexion of the foot develops. The nurse includes interventions in the plan of care to address which condition?

Footdrop

The nurse provides a client with a label from an ice cream container and asks specific questions about the information on the label. What is the nurse assessing in this client?

Health literacy

A client reports not feeling well and thinks it could be related to stress. Which assessment finding should the nurse expect in this client?

Heart rate 110 bpm

A nurse delegates the task of assisting patients with ambulation to a nursing assistant. The nurse intervenes when observing the nursing assistant implements which action?

Holds the transfer belt loosely near the patient's body while ambulating

During an assessment, a client reports performing self-care techniques to balance the hot disease state of diabetes. Which health belief should the nurse realize that this client practices?

Holistic

The nurse is evaluating a client's understanding of teaching regarding home oxygen therapy. Which statement by the client indicates that teaching been effective?

I should avoid wearing wool blankets or sweaters.

An LPN/LVN is assisting the RN in caring for a client who is newly diagnosed with chronic obstructive pulmonary disease (COPD). The client cares for a spouse at home who also has COPD. When formulating a nursing diagnosis for this client, the RN selects "Readiness for enhanced knowledge." The RN sits down with the client and presents the information included in his or her teaching plan. Which step in the nursing process would this be considered?

Implementation

A patient has been placed on a feeding tube. To prevent aspiration, in which position does the nurse place the patient's bed?

In a semi-Fowler position

Which of the following are examples of wellness strategies? Select all that apply.

Providing tips on how to quit smoking Providing tips on changing how much alcohol one consumes Emphasizing the importance of regular exercise

Children in preschool often learn from pretending, role-playing, and exploring the identities of adults in various positions, such as nurses, doctors, teachers, police officers, firefighters, and others who serve as role models. A nurse identifies this as an example of which type of behavior?

Psychosocial development

The nurse is extinguishing a fire that has broken out in the workplace. Which is the first step the nurse should take?

Pull the pin found between the handles

Which certified nursing assistant (CNA) action while making a bed for a patient who is out receiving therapy requires an intervention by the nurse?

Puts soiled linens on the floor

The nurse provides care to a patient who experiences dyspnea. The patient states, "I don't want to take any more medication." Which nonpharmacological intervention does the nurse implement for this patient?

Putting a fan near the bed to circulate the air

The nurse is participating in a community health screening. Which suggestion should the nurse make to a client to help cope with stress? Select all that apply.

Relax with family and friends. Say no when one has other obligations. Eliminate excessive possessions.

A nurse is working on a nursing unit when an electrical fire starts. Which action should the nurse take first?

Remove clients from immediate danger.

When delegating patient bedtime care to a nursing assistant, the nurse intervenes if which is observed?

Removing the patient's urinal

A pregnant nurse is assigned to a client undergoing internal radiation therapy for thyroid cancer. What precautions should the nurse take?

Request an alternative assignment.

A nurse instructs a postpartum client who wishes to breastfeed to gently touch the newborn's cheek that is closest to the breast to cause the baby to tum toward the breast and open the mouth to find milk. Which reflex is the nurse describing the client to elicit?

Rooting reflex

The nurse gathers data for a child who is 8 years of age during a well-child visit. Which stage of development does the nurse document for this child in the medical record?

School-ager

The nurse observes an infant picking up items and immediately placing the items in the mouth. When documenting this observation, the nurse identifies that the infant is encouraging cognitive development through which concept?

Sensorimotor experiences

A nurse delegates activities of daily living (ADLS) to a certified nursing assistant (CNA). ADLS that can be delegated CNA include which of the following? Select all that apply.

Shaving a patient Showering a patient Assisting a patient with dressing Assisting a patient with denture care

Which term does the nurse include in the plan of care for skin that slides over another surface in the opposite direction, which increases the risk of abrasions and open skin areas?

Shearing

A nurse provides oral care to an unconscious patient. Which patient position enhances the patient's safety during this procedure?

Side lying

A student nurse has received a prescription for a narcotic pain reliever due to chronic back pain. Which action should the student nurse take?

Speak confidentially with an instructor.

The staff is caring for a client with a wound contaminated with methicillin-resistant staphylococcus amureus (MRSA). Which precautions would the nurse expect to adhere to when caring for this client? Select all that аpply.

Standard Contact

While educating a class of nursing students, a nursing instructor teaches which about back massages? Select all that apply.

Stimulate circulation Prevent pressure ulcers Can cause vagus nerve depression

A nurse encounters a bed made up with the top linens fanfolded to the side of the bed, The nurse documents this as which type of bed?

Surgical

A client has been diagnosed with septicemia, a condition in which microorganisms are present and multiplying in the blood. A nurse identifies this condition as a:

Systemic infection.

A terminally ill patient refuses to take adequate pain medication. The patient expresses worry that the use of pain medication may result in addiction. Which response by the nurse is appropriate?

Teach the patient that addiction is not a concern during the terminal stages of illness.

The nurse provides care to an older adult client who displays a fearful attitude toward the nurse when care is provided. The client has multiple unexplained bruises, and several old fractures appear on the x-ray that were never treated. Which does the nurse suspect based on the current data?

The client may have been abused by a caregiver.

A client who is admitted for observation following an episode of chest pain relieved by rest and two nitroglycerin tablets reports having a job as CEO of a large firm that is becoming too much to handle. According to Selye, what should the nurse suspect the client is experiencing?

The exhaustion phase of stress

The nurse is discussing health with a client. What should the nurse explain about health being measured on a continuum scale?

The higher the measurement is, the better one's health is.

While assisting the primary nurse who is manually transferring a patient from a bed to a chair, the nurse intervenes when the primary nurse implements which action during the transfer?

Twisting at the torso

Which of the following items increase a client's risk for falling, according to the Morse Fall Scale? Select all that apply.

Use of a cane Has an IV/saline lock Requires nurse-assisted ambulation Has altered mental status

The nurse is caring for a client who is 75 years old. When teaching the client, the nurse should:

Use pleny of repetition

Which of the following are considered part of standard precautions? Select all that apply.

Washing hands with soap and water Wearing gloves when drawing blood Covering mouth and nose when sneezing Donning a mask when suctioning

The nurse is caring for the client with Clostridium difficile. Which actions should nurse take? Select all that apply.

Wear a gown when caring for the client. Put on gloves before entering the client's room.

The nurse prepares to address a client's spirituality concerns. Which should the nurse assess first?

Whether the client practices a religion

The nurse gathers data from a client who will be headed off to college in the fall, The client states, "I am developing my own spiritual beliefs that are different from my parents." According to Fowler, which stage of spiritual development does the nurse document in the client's medical record?

Individuating-reflexive

A client reports living in an apartment located in an area of high crime and drive-by shootings. Which leading health indicator most likely will impact this client's health?

Injury and violence

A nurse is performing an initial admission assessment on a client. The client states that he takes chamomile, The nurse suspects that the client has which of the following?

Insomnia

The nurse provides care to a patient who is prescribed palliative care. The patient asks, "What is the difference between hospice care and palliative care?" Which does the nurse include in the response to the patient regarding palliative care?

It may be aggressive and is directed at eliminating discomfort.

An experienced nurse is teaching a nursing student about body mechanics. Which statement made by the experienced nurse is accurate? Select all that apply.

It's important to understand that your center of gravity is your body's Your base of support comes from your lower legs. Hold heavy items close to your body when lifting.

A nursing instructor supervises a student nurse who is caring for a client who is on fall precautions. The nursing instructor would intervene if he or she observed the student nurse:

Keeping the bed at the highest position at all times.

A client who underwent a carotid endarterectomy asks a nurse about care for his neck incision. The client informs the nurse that he is an auditory learner. The nurse determines that the client will learn best by:

Listening to the nurse's verbal instructions about care of the incision.

The nurse provides care to a patient who has a written document containing medical decisions should the patient be unable to make them as the illness progresses. Which end-of-life documentation does the patient have based on the current information?

Living will

When providing a bed bath, the nurse monitors the patient's skin. The nurse observes an area of skin on the buttocks that is softened from continuous exposure to urine. Which term does the nurse use when documenting this finding?

Maceration

The nurse provides care to a patient who is at risk for integumentary complications. Which interventions does the nurse include in the patient's plan of care based on this information? Select all that apply.

Maintaining adequate nutrition Using mild soaps for cleansing the skin Inspecting bony prominences at least every 2 hours

The nurse reinforces teaching for the caregiver on an immobile patient who will be discharged home soon. Which caregiver action when supervising care indicates the need for the nurse to intervene?

Massaging directly on reddened bony prominences

An LPN/LVN assists with educating a client who has just been diagnosed with rheumatoid arthritis. The client asks where he can find information on the Internet. The nurse's best recommendation is to view which of the following sites? Select all that apply.

Mayo Clinic's website Websites ending in ".org" or ".gov"

A nurse enters a room to assist a client who has used the bedside commode, The nurse washes the client's hands, puts on clean gloves, assists the client in cleaning the genital area, and then assists the client into bed. The nurse then empties, rinses, and replaces the pan of the bedside commode. The nurse removes the gloves and washes his or her bands. Which is the nurse practicing?

Medical asepsis

A nurse is performing an admission assessment on a client who states that he adheres to a discipline in which the mind is focused on an object of thought or awareness, and usually involves tuning attention to a single point of reference. The nurse recognizes that the client participates in which of the following?

Meditation

A client is admitted to the hospital with tuberculosis. Before providing care, which of the following personal protective equipment should be worn? Select all that apply.

N95 or higher respirator Gown Eye protection Gloves

Performing hair care gives a nurse a chance to monitor a patient's scalp for which of the following? Select all that apply.

Nits Seborrhea Tinea capitis

The nurse provides care to a terminal patient who is approaching end of life. Which information does the nurse reinforce with the family members as indicating death is very near? Select all that apply.

Nonresponsiveness Slow and thready pulse Mottling of feet and legs Edema of lower extremity

A charge nurse supervises an unlicensed assistive personnel (UAP) while providing care to a client at risk for falls. The client repeatedly attempts to get out of bed without assistance. The charge nurse intervenes when observing which action by the UAP?

Offering infrequent opportunities for the client to go to the bathroom

The nurse plans care for a patient who has a history of becoming dizzy, pale, clammy, and nauseated when moving from a lying position to a sitting position. The nurse plans interventions to prevent which condition?

Orthostatic hypotension

To help reduce hospital-acquired infections (HAIS), the nurse's first priority is to:

Perform strict hand washing before and after care of each client

During adolescence, girls develop breasts and boys develop facial hair. The nurse documents these findings as a normal stage of which type of development?

Physical

An older client with a chronic illness lives alone, has a fixed income, and often cannot afford required medications. which quadrant on Dunn's wellness grid should the nurse categorize this client?

Poor health in an unfavorable environment.

A nurse is caring for a client who has been attending a local university to earn a law degree. The client states, "I want to earn my degree so that I can fight for justice and human rights for people throughout the world." The nurse recognizes that the client is in which stage of Lawrence Kohlberg's moral development theory?

Postconventional morality

The nurse provides care to an older adult patient who requires assistance with the removal of newly custom-fit hearing aids. Which is the first action by the nurse when assisting the patient with this task?

Powering the hearing aid down

After learning of a 20-lb. weight gain over the last year, the client says, "My spouse makes me nervous and all I do is eat." Which defense mechanism is this client demonstrating?

Projection

An older adult patient becomes progressively more confused. The patient begins talking to long-gone loved ones about places and events that do not make any sense to the family. Which is the priority nursing action based on the current information?

Protect the patient from injury by bed rails or equipment.

A nurse is caring for a visually impaired client who requires discharge instructions. When speaking with the client, the nurse should do which of the following?

Provide the client with larger-print handouts.

The nursing instructor is preparing a training tool that addresses transcultural nursing. Which information about transcultural care should be included on this tool?

crosses cultural boundaries.

A nurse is caring for a client with a fever of 103.2°F. The client's wife asks, "Why does his body get so hot like that?" Which is the best response by the nurse?

"A fever is the body's way of creating an environment that is harmful to gernms."

The nurse provides care to a patient who is actively dying. The patient's spouse is upset about her husband's respirations. Which response by the nurse is appropriate when providing education to the spouse about Cheyne-Stokes respirations?

"As your husband approaches end of life, breathing will be a cycle of shallow and deep respirations."

The nurse is caring for a client with diabetes who has just been educated on how to monitor and manage blood glucose levels. Which questions asked by the nurse will effectively evaluate the client's understanding?

"Can you show me how to use your blood glucose machine?" "Can you explain what actions to take if your blood glucose is low?" "What will you do if your blood glucose is too high?" "How do you dispose of used insulin needles?"

The nurse gathers data for a pediatric client who is experiencing a developmental delay. Which question does the nurse ask to determine if the delay is due to biological factors?

"Did your child experience a lack of oxygen during the birth process?"

A nurse is supervising a student nurse. When providing client teaching, the nurse intervenes when the student nurse states which of the following?

"Why didn't you do it the way that I showed you?"

A nurse is caring for a client on bedrest who repeatedly attempts to get out of bed without assistance, Which is the most therapeutic response by the nurse?

"Would you like me to give you a back rub?"

The nurse is caring for a client who has been placed in restraints. Which statements made to the client by the nurse indicate an understanding of following restraint guidelines of the Centers for Medicare and Medicaid Services (CMS) and The Joint Commission? Select all that apply.

"Would you like some water?" "Do you need help going to the bathroom?" "Let's change the position you're lying in." "We'll remove these in about an hour.

The mother of a 1-year-old child asks a nurse how much her child should weigh. At birth, the child weighed 7 pounds and 8 ounces. Based on this information, the nurse tells the mother the child should be which weight?

22.5 pounds

The mother of a 9-year-old boy is concerned that her son is gaining weight too quickly for his age. Which is the range of weight gain that is expected during the ages of 5 and 12 years that the nurse shares with this mother?

4.5 to 6.5 pounds per year.

The charge nurse recognizes that a client with which score on the Morse Fall Scale is at the highest risk for falling?

55

The nurse provides care to a terminal patient who states, "I don't need anything from you. Leave me alone!" Based on this information, the nurse documents that the patient is likely experiencing which stage of grief?

Anger

Which type of care does the nurse include in the plan of care for a patient who requires assistance bathing the lower extremities?

Assisted care

The nurse encourages a patient to take full, deep breaths to keep the alveoli open to prevent which complication from occurring?

Atelectasis

A client presents with high fever, rash, and breathing difficulty. The client's history notes that the client is a park ranger who spends most days outside in heavily wooded areas. The client notes that he stepped in a tick nest recently, as well. Which treatment does the nurse expect?

Antibiotic

The mother of a 9-year-old client with a viral infection is demanding that the client be administered an antibiotic to treat the infection. Which is the most appropriate response?

Antibiotics would not be effective against a viral infection.

A nurse is caring for a client whose primary language is different from the nurse. The client needs preoperative education. The nurse best demonstrates a caring demeanor through which of the following actions?

Arranging for an interpreter or translator to be present

A client from a non-English speaking culture is dying. Which should the nurse do to ensure that this client receives culturally specific care?

Ask if there are any specific cultural interventions at this time.

The nurse provides care to a toddler-aged client who is hospitalized. Which intervention does the nurse implement to promote the toddler's autonomy?

Asking the child to choose between chocolate or vanilla pudding

client is demonstrating signs of spiritual distress. In which way would the nurse fail to provide spiritual care to this client?

The nurse does not understand the relationship between mind, body, and spirit.

The nurse is caring for a client who has been treated in the hospital for bacterial meningitis for several weeks. Which actions by the nurse indicate the nurse understands the psychological aspects of the client's care? Select all that apply.

The nurse spends time talking to the client while in the room. The nurse offers to bring the client a magazine. The nurse speaks to the client without distaste.

The RN is observing the student nurse caring for a client. Which actions by the student indicate that the student understands how to maintain a safe and clean environment? Select all that apply.

The student disinfects an IV pump after every use. The student dons gloves prior to emptying a bedside commode. The student washes his or her hands before and after caring for each client. The student uses gloves when handling equipment with dried blood.


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