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A nurse is caring for a client who has a terminal illness and is at the end of life. The nurse should recognize that which of the following statements by the client's partner indicates effective coping?

"I am relying on support from our family during this time."

A nurse is preparing to administer 0.9% sodium chloride 750 mL IV to infuse over 7 hr. The nurse should set the infusion pump to deliver many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

107

A nurse is performing a skin assessment for a client who expresses concern about skin cancer. Which of the following findings should the nurse identify as a potential indication of a skin malignancy?

A mole with an asymmetrical appearance?

A nurse is planning care for a client who had a stroke resulting in aphasia and dysphasia. Which of the following tasks should the nurse assigned to an assistive personnel? (Select all that apply)

A) Assist the client with a partial bed bath B) measure the client's BP after the nurse administers an antihypertensive medication D) use a communication board to ask what the patient wants for lunch

A nurse is responding to a call light and finds a client lying on the bathroom floor. Which of the following actions should the nurse take first?

Check the client for injuries.

A nurse is reviewing a client's fluid and electrolyte status which of the following findings should the nurse report to the provider?

D. Potassium 5.4 mEq/L

A nurse is administering an otic medication to an older adult client. Which of the following actions should the nurse take to ensure that the medication reaches the inner ear?

Press gently on the tragus of the client's ear

A nurse is performing a home safety assessment for a client who is receiving supplemental oxygen. Which of the following observations should the nurse identify as proper safety protocol?

The client uses nonacetone nail polish remover.

medications. The client has recently developed A home health nurse is performing a follow-up visit for a client who has a gastrostomy tube through which they receive intermittent feedings and diarrhea. Which of the following findings should the nurse identify as a possible cause of the diarrhea?

The client's caregiver washes out the feeding bag with warm water once every 24 hr.

A nurse is caring for a client who has dementia. Which of the following interventions should the nurse take to minimize the risk for injury to the client?

Use a bed exit alarm system.

A nurse is planning strategies to manage time effectively for client care. Which of the following strategies should the nurse implement?

Use the planning step of the nursing process to prioritize client care delivery.

A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse implement for this client?

Wear a gown when caring for the client.

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nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?

make sure the client wears a mask

for the the client rest of should indication developed a bed Which an as has assessing on findings been month. identify client is nurse has past the nurse that thrombophlebitis? A who the following

swelling Calf

A nurse is preparing to administer enoxaparin subcutaneously to a client. Which of the following actions should the nurse take?

Administer the medication with the needle at a 45° angle.

A nurse is educating a client who has a terminal illness about her request to decline recipe cetacean and her living well. The client asked what would happen if she arrived at the emergency department and had difficulty breathing. Which of the following responses should the nurse provide?

B) we will apply oxygen through a tube in your nose

nurse continuity Which or the a report. tools preparing should following communicate is nurse change-of-shit of the use of documents to care? Critical A

and assessment, background, (SBAR) Situation, B. recommendation

A nurse is providing discharge instructions to a client who will be using a walker. Which of the following client statements indicates an understanding of the teaching?

"I will hire someone to trim the tree that hangs low over the stairs of my front porch."

A nurse is preparing an education program for staff about advocacy. Which of the following information should the nurse include?

Advocacy ensures clients' safety, health, and rights.

A nurse is caring for a client who has a sodium level of 125 mEq/L. Which of the following findings should the nurse expect?

D) abdominal cramping

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precautions Contact

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process admission during A)

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promote to esophagus water the of into sips tube take NG the client of the insertion Have

A nurse is assessing a client's readiness to learn about insulin self-administration. Which of the following statements should the nurse identify as an indication that the client is ready to learn?

"I can concentrate best in the morning." are at

A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following understands the preoperative teaching she received about pain management? indication that the client statements should the nurse identify as an

"It might help me to listen to music whille I'm lying in bed."

A nurse is talking with an older adult client who is contemplating retirement. The client states, "I keep thinking about how much I enjoy my job. I'm not sure I want to retire." Which of the following responses should the nurse make?

"Let's talk about how the change in your job status will affect you.

A nurse is caring for a client who has herpes zoster and asks the nurse about the use of complementary and alternative therapies for pain control. The nurse should inform the client that this condition is a contraindication for which of the following therapies?

Acupuncture

A nurse is caring for a client who is postoperative. When the nurse prepares to change her dressing, she says, "Every time you change my bandage, it hurts so much." Which of the following interventions is the nurse's priority action?

Administer paln medication 45 min before changing the client's dressing

A nurse is providing discharge teaching to a client about self-administering heparin. Which of the following instructions should the nurse include in the teaching?

Administer the medication into the abdomen

A nurses caring for a group of clients. Which of the following actions should the nurse take to prevent the spread of infection? A) carry a clients soil linens out of the room in a mesh linen bag B) place a client who has tuberculosis in a room with negative pressure airflow C) provide disposable plates and utensils for a client who is HIV positive D) dispose of the clients blood saturated dressing in a trash bag inside a second trash bag

B) place a client who has tuberculosis in a room with negative pressure airflow

A nurse is reviewing evide hce- based practice principles about administration of oxygen therapy with a newly licensed nurse. Which of the following actions should the nurse include? A) regulate the flow rate by aligning the rate with the top of the ball inside the flowmeter B) regulate auction oxygen via nasal cannula out of low rate of no more than 6 L C) make sure the reservoir bag of a partial rebreathing mask remains deflated D) use petroleum jelly to lubricate the client's nares, face and lips

B) regulate auction oxygen via nasal cannula out of low rate of no more than 6 L

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C) mind I am available to talk if you should change your

A nurse is preparing to apply a dressing for a client who has a stage 2 pressure injury. Which of the following types of dressing should the nurse use?

Hydrocollold

A nurse is lifting a bedside cabinet to move it closer to a client who is sitting in a chair. To prevent self-injury, which of the following actions should the nurse take when lifting this object?

Stand close to the cabinet when lifting it.

A nurse is using an open irrigation technique to irrigate a client's indwelling urinary catheter. Which of the following actions should the nurse take?

Subtract the amount of irrigant used from the client's urine output; the nurse should calculate the fluid used for irrigation and subtract it from the client's total urinary output.

nurse continuity Which or the a report. tools preparing should following communicate is nurse change-of-shit of the A use of documents to care?

and assessment, background, (SBAR) Situation, B. recommendation

nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?

pad the client's wrist before

a of an should insert for Which take? to catheter actions to planning IV client. plan is adult following nurse A nurse peripheral older the the

position dependent a in arm client's the Place B.

at for following nurse cannula client care a to the tracheostomy the of teaching? outer teaching how should the family Which the in is client's Remove nurse his A and the home. instructions include

outdoors when covers tracheostomy Use b)

A nurse is assessing four adult clients. Which of the following physical assessment techniques should the nurse use?

Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.

Obtain the pronouncement of death from the provider. Remove tubes and indwelling lines. Wash the client's body. Ask the client's family members if they would like to view the body. Place a name tag on the body.

FLAG

nurse is assessing a client who reports increased pain following physical therapy. Which of the following questions should the nurse ask when assessing the quality of the client's pain?

is your pain sharp or dull

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overload Role C.

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rate heart in decrease C)

of client a and major Which nurse's for incentive an following surgery. the postoperative caring use is action? is to following nurse is A who refuses spirometer abdominal the priority

to refusing is client the why spirometer. reasons the incentive Determine the use

A nurse manager is preparing to review medication documentation with a group of newly licensed nurses. Which of the following statements should the nurse manager plan to include in the teaching?

"Use the complete name of the medication magnesium sulfate."

A nurse is evaluating a client's use of a cane. Which of the following actions should the nurse identify as an indication of correct use?

The client holds the cane on the stronger side of her body.

A nurse is admitting a new client. Which of the following actions should the nurse take while performing medication reconciliation?

Compare the client's home medications with the providers prescriptions.

A nurse is caring for a client who is postoperative following a knee arthroplasty and requires the use of thigh-length sequential compression sleeves. Which of the following actions should the nurse take?

Make sure two fingers can fit under the sleeves

A nurse is auscultating the anterior chest of a client who was newly admitted to a medical-surgical unit, Listen to the audio clip of what the nurse auscultates through the stethoscope and identify the type of breath sounds. (Click on the audio button to listen to the clip.)

Normal breath sounds