Nursing Concepts Advanced Test

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A nurse is reinforcing teaching with a client who is prescribed buspirone (BuSpar). Which of the following statements by the client indicates an understanding of the teaching?

"I can have 1-2 alcoholic beverages a week." The content of this question emphasizes the concept of client education by determining which statement by the client indicates effectiveness of the teaching. Client education is the provision of health-related education to clients to facilitate the acquisition of new knowledge and skills, adoption of new behaviors, and modification of attitudes. It is important that evaluation of teaching is an ongoing process instead of one that occurs only in the final stages of the teaching process. Continual evaluation allows for adjustments to be made as needed to enhance or improve learning. Buspirone is an anxiolytic medication used to treat anxiety, but is different from benzodiazepines because of the fact that it is not a CNS depressant. Because of this, buspirone does not interfere with CNS depressants, such as benzodiazepines, alcohol, or barbiturates, and it is acceptable to have 1 to 2 alcoholic beverages each week. This statement by the client is true and indicates an understanding of the teaching.

A nurse is reinforcing teaching about client consent to treatment with a group of newly licensed nurses. Which of the following statements by a newly licensed nurse indicates a need for further teaching?

"It is the responsibility of the provider to obtain express consent." The content of this question emphasizes the concept of professionalism by ensuring understanding of the legal concept of consent. Professionalism incorporates legal and ethical principles, as well as compliance with the standards of nursing practice in the provision of safe, quality nursing care that exhibits both accountable and responsible behaviors. Nurses frequently obtain express consent by witnessing a client sign a consent form after ensuring the client has received and understands necessary information regarding the procedure. This is not an appropriate statement by a newly licensed nurse and requires further teaching. Know implied consent

A nurse is caring for a school-age child who is newly diagnosed with type 1 diabetes mellitus. Which of the following actions by the nurse is appropriate to prepare the child for administration of insulin?

Allow the child to manipulate the medical equipment The content of this question emphasizes the concept of client-centered care by implementing age-appropriate strategies to prepare a client for a procedure. Client-centered care focuses on the client and emphasizes the client's cultural, ethnic, and social values. By using age-appropriate strategies, nurses facilitate the provision of individualized, high-quality care. Allowing the child to manipulate the equipment facilitates mastery and gives the child a sense of accomplishment. This action is appropriate when preparing a school-age child for a procedure. preschool-provide a toy doctor's kit to play with

A nurse is caring for a neonate who was delivered at 30 weeks of gestation after his mother received two injections of betamethasone (Celestone). Because of the administration of betamethasone to the client's mother, the nurse should monitor the neonate for which of the following effects?

Hypoglycemia The content of this question emphasizes the concept of safety through the recognition of a potential adverse effect that can result in physical harm. Safety in nursing practice is the minimization of risk factors that can cause harm while promoting quality care and maintaining a secure environment for clients, self, and others. Improving the safety of medications is a major goal of the National Patient Safety Goals. Through the provision of client-centered care and incorporation of evidence-based practice, nurses are able to assist in achieving this goal by preventing or minimizing physical injury. Betamethasone is a glucocorticoid used in the prevention of respiratory distress syndrome in premature infants. Betamethasone causes hyperglycemia in the mother, which predisposes the neonate to hypoglycemia in the first hours after delivery. stop pick the confuse word- sternal retraction

A nurse at a long-term care facility is participating in a quality improvement project to reduce the occurrence of pressure ulcers. Which of the following audits should be conducted to determine the impact of a new skincare regimen on the incidence of pressure ulcers among clients who are immobile?

Outcome audit The content of this question emphasizes the concept of quality improvement by selecting the appropriate audit to conduct when determining the impact of a new skincare regimen on the incidence of pressure ulcers among clients who are immobile. The primary goal of quality improvement is developing and implementing a plan to improve health care services and better meet the needs of clients. To accomplish this goal it is necessary to recognize client and facility issues that impact the provision of safe, quality care, as well as identify gaps between current practices and best practices. Audits are a process of measuring the quality of delivered care so better practices can be developed and implemented when needed. An outcome audit is conducted to determine the actual result a specific nursing intervention has had on client outcomes. This type of audit is appropriate to use when determining the impact of a new skincare regimen on the incidence of pressure ulcers among clients who are immobile.

A nurse has assigned four tasks to an assistive personnel (AP). Which of the following should the nurse instruct the AP to perform first?

Take an ABG specimen to laboratory The content of this question emphasizes the concept of leadership by prioritizing completion of assigned tasks. Leadership is the process by which nurses use a set of skills that directs and influences others in the provision of individualized, safe, quality client care. When making assignments, a leader should be certain to include a timeline for completion. ABG samples are kept on ice and should be transported immediately to the laboratory or the specimen will deteriorate, which will cause inaccurate and meaningless results. This is the task the nurse should instruct the AP to perform first. transport a client to the radiology department for an x-ray second, unless the x-ray is prescribed as STAT

A charge nurse on the pediatric unit is making assignments for a nurse who has floated from the labor and delivery unit. Which of the following clients is appropriate for the charge nurse to assign?

an adolescent who is 2 days post operative following an appendectomy The content of this question emphasizes the concept of leadership through the coordination of client care by making appropriate assignments. Leadership is the process by which nurses use a set of skills that directs and influences others in the provision of individualized, safe, quality client care. When making assignments, a leader should effectively communicate and have knowledge of the skill sets of team members in order to ensure clients receive care by the most appropriate person on the team. The care of an adolescent who is 2 days postoperative following an appendectomy requires postoperative care including education, infection prevention, and medications that require fundamental nursing skills and knowledge; therefore, it is appropriate to assign this client to the nurse who has floated from the labor and delivery unit.


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