Fundamentals - Basics

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A nurse is caring for a client with hemiplegia who is frustrated. How can the nurse motivate the client toward independence? 1.Establish long-range goals for the client. 2.Identify errors that the client can correct. 3.Reinforce success in tasks accomplished. 4.Demonstrate ways to promote self-reliance

3.Reinforce success in tasks accomplished.

Which task is most appropriate for a nurse to delegate to unlicensed assistive personnel? 1.Emptying a portable wound drainage device. 2.Instructing a client to use an incentive spirometer. 3.Monitoring the rate of infusion of intravenous fluids. 4.Assessing the blood pressure of a client before physical therapy

4.Assessing the blood pressure of a client before physical therapy

The nurse is caring for a client that underwent a rhinoplasty surgical procedure 5 hours ago. After administering pain medication, the nurse notes the client is swallowing frequently. The nurse understands that the cause of frequent swallowing is most likely caused from: 1.A normal response to the analgesic 2.Oral dryness caused by nasal packing 3.An adverse reaction to anesthesia 4.Bleeding posterior to the nasal packing

4.Bleeding posterior to the nasal packing

Ceftriaxone (Rocephin) 2.5 g intravenous piggyback (IVPB) every 8 hours is prescribed for a client with a severe infection. The pharmacy sends a vial labeled 5 g per 10 mL. What volume of ceftriaxone should the nurse add to the IVPB solution? Record your answer using a whole number. __________ mL

Have 5 g 10 mL 5x = 25 x = 25 ÷ 5 x = 5 mL

A nurse is teaching members of a health care team how to help disabled clients stand and transfer from the bed to a chair. To protect the caregivers from injury, the nurse teaches them to lift the client by first placing their arms under the client's axillae and next: 1.Bending and then straightening their knees 2.Bending at the waist and then straightening the back 3.Placing one foot in front of the other and then leaning back 4.Placing pressure against the client's axillae and then raising their arms

1.Bending and then straightening their knees

A nurse is taking care of a client who is extremely confused and experiencing bowel incontinence. What measures can the nurse take to prevent skin breakdown in this client? 1.Instruct the client to call for help with elimination needs; answer the client's call light immediately to avoid incontinence. 2.Place a waterproof pad under the client to prevent incontinence and soiling the linens. 3.Check the client's buttocks at least every two hours; clean the patient immediately after discovering incontinence. 4.Offer toileting to the client every two hours to prevent incontinence.

3.Check the client's buttocks at least every two hours; clean the patient immediately after discovering incontinence.

A client is placed on a stretcher and restrained with straps while being transported to the x-ray department. A strap breaks, and the client falls to the floor, sustaining a fractured arm. Later the client shows the strap to the nurse manager, stating, "See, the strap is worn just at the spot where it snapped." What is the nurse's accountability regarding this incident? 1.Exempt from any lawsuit because of the doctrine of respondeat superior 2.Totally responsible for the obvious negligence because of failure to report defective equipment 3.Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client 4.Exonerated, because only the hospital, as principal employer, is responsible for the quality and maintenance of equipment

3.Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client


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