Unit 2 Application Exercise

In what ways can a nurse prevent medication errors? Select all that apply. 1 Avoid using abbreviations and acronyms 2 Minimize the use of verbal and telephone orders 3 Try to guess what the client is saying if the language is not understood 4 Document each dose of the drug using trailing zeros when recording the dose 5 Check three times before giving a drug by comparing the drug order and medication profile

1 Avoid using abbreviations and acronyms 2 Minimize the use of verbal and telephone orders 5 Check three times before giving a drug by comparing the drug order and medication profile The use of abbreviations is avoided because this action may cause confusion and increase the risk of error. The use of verbal and telephone orders should be minimized to avoid confusion over drugs that have similar names. Before a drug is administered, the dosage order should be checked three times to verify the five rights: right drug, right dose, right time, right route, and right client. The use of trailing zeros should be avoided because it increases the risk of overdose. If the client's language is not understood, a translator's help should be enlisted.

Which gross-motor skills would the nurse explain are developed in children between 3 to 5 years of age? Select all that apply. 1 Jumping rope 2 Walking stairs 3 Drawing circles 4 Stacking blocks 5 Drawing triangles

1 Jumping rope Examples of the gross motor skills that a preschooler learns are jumping rope and walking up and down steps with ease. Fine-motor capabilities in a toddler include drawing circles and crosses accurately. By 3 years of age, the child draws simple stick people and is usually able to stack a tower of small blocks. Triangles and diamonds are usually mastered between ages 5 and 6 years of age.

A nurse gathers data about the success of keeping the side rails of clients' beds up at nighttime to reduce the risk of falls. Which competency does the nurse display according to the Institute of Medicine (IOM) competencies of the 21st century? 1 Using informatics 2 Applying quality improvement 3 Using evidence-based practice 4 Working in interdisciplinary teams

2 Applying quality improvement According to the Institute of Medicine (IOM) competencies of the twenty-first century, nurses are required to incorporate quality improvement into their work. A nurse performs this task by identifying potential hazards, designing interventions to improve quality, and evaluating the success of the strategies. In the given situation, the nurse is evaluating the success of a strategy to minimize clients' risks of falls. Using informatics involves the use of information technology for the purposes of communication, management of knowledge, and reduction of errors. Using evidence-based practice involves participating in research activities and integrating results of research with client care. A nurse is required to work with interdisciplinary teams to provide better care to clients. This action is done by cooperating and collaborating with the client, caregivers, and other health care workers.

The nurse is preparing to conduct a scheduled health maintenance visit for a 15-month-old toddler-age client. Which information should the nurse include in the teaching session with the toddler's parents related to socialization and cognition? 1 Engages in parallel play 2 Imitation of parental activities 3 An elevated fear of strangers 4 Tolerates long periods of parental separation

2 Imitation of parental activities The 15-month-old toddler will imitate parental activities such as cleaning house or sweeping the floors; therefore, this is an appropriate topic for the nurse to include in the teaching session. Engagement in parallel play does not occur until approximately 24 months of age. The 15-month-old toddler will have a decreased, not elevated, fear of strangers. The 15-month-old toddler tolerates some, but not long, periods of parental separation.

A nurse is educating the mother of a seven-month-old child about an adequate diet plan for the child. Which statement made by the nurse should be included? 1 "You should provide up to 4 to 6 cups of milk per day." 2 "You should refrain from serving finger food and feed the child." 3 "You should supplement milk with solid food items like vegetables and fruits." 4 "It is preferably to provide low-fat or skimmed milk until the baby is 2 years old."

3 "You should supplement milk with solid food items like vegetables and fruits." When the child is 6 months old, the mother should start supplementing the child's intake of milk with solid food items to ensure a balanced diet for adequate growth. The intake of milk should be limited to 2 to 3 cups per day because the consumption of more than a quart of milk per day tends to decrease the child's appetite for essential solid foods and results in inadequate iron intake. Serving finger foods to toddlers allows them to eat by themselves and to satisfy their need for independence and control. Small, reasonable servings allow toddlers to eat all of their meals. Children below 2 years of age should not be given low-fat or skimmed milk because the fat is important for the physical and intellectual growth of the child.

Which pregnancy safety category shows a proven risk of fetal harm, but potential benefits of use during pregnancy may be acceptable despite its risks? 1 Category A 2 Category C 3 Category D 4 Category X

3 Category D Category D drugs show a proven risk of fetal harm; however, potential benefits of its use during pregnancy are acceptable in case there is a life-threatening disease. Category A drugs pose little to no risk of fetal harm. Category X drugs have been proven to harm the fetus; the risks outweigh the possible benefits of using this drug. Category C drugs have harmed animal fetuses, but there is no conclusive evidence that the drug may harm human fetuses.

Which group of the pediatric population is at a higher risk of developing respiratory complications upon administration of general anesthesia? 1 Infants 2 Children 3 Neonates 4 Adolescents

3 Neonates The physical characteristics of the larynx and small airway diameter, the structure of the respiratory system, and the high metabolic rate of neonates place them at a higher risk than infants, children, or adolescents of developing respiratory complications from anesthesia.

A client who has a hemoglobin of 6 gm/dL (60 mmol/L) is refusing blood because of religious reasons. What is the most appropriate action by the nurse? 1 Call the chaplain to convince the client to receive the blood transfusion. 2 Discuss the case with coworkers. 3 Notify the primary healthcare provider of the client's refusal of blood products. 4Explain to the client that they will die without the blood transfusion.

3 Notify the primary healthcare provider of the client's refusal of blood products. The nurse serves as an advocate for the client to uphold their wishes. Synthetic blood products are available but must be prescribed by the primary healthcare provider. Therefore the primary healthcare provider needs to be notified of the client's refusal for blood so alternatives can be considered. The chaplain's role is to offer support, not to convince the client to go against beliefs. It is a Health Insurance Portability and Accountability Act (HIPAA) (Canada: Personal Health Information Protection Act [PHIPA]) violation to discuss the case with coworkers unless they are involved in the care of the client. The nurse should not use threats or fear to coerce the client.

The nurse at a community healthcare center focuses on providing primary preventive care. What is the focus of primary preventive care? 1 Rehabilitating the client 2 Treating early stages of disease 3 Preventing complications from illness 4 Promoting health in healthy individuals

4 Promoting health in healthy individuals Primary prevention precedes disease or dysfunction and is applied to patients considered physically and emotionally healthy. Health education programs, immunizations, and physical and nutritional fitness activities are primary prevention activities. Tertiary preventive care occurs when an individual has a permanent or irreversible disability. The client undergoing rehabilitation is receiving tertiary preventive care. Secondary preventive care focuses on individuals who are experiencing health problems. Secondary preventive care involves treating clients in the early stages of disease. It also focuses on preventing complications from illness.

The nurse at a health fair has taken a client's blood pressure twice, 10 minutes apart, in the same arm while the client is seated. The nurse records the two blood pressures of 172/104 mm Hg and 164/98 mm Hg. What is the appropriate nursing action in response to these readings? 1 Refer the client to a nutritionist after providing health teaching about a low-sodium diet. 2 Place the client in a recumbent position and call the paramedics for transport to the hospital. 3 Talk with the client to assess whether there is stress in the client's life and refer to a counseling service. 4 Take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible.

4 Take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible. According to the United States Department of Health and Human Services (Canada: Canadian Heart and Lung Association), both of these readings indicate hypertension and thus require further evaluation by a healthcare provider; having a baseline for both arms can assist the healthcare provider with the medical diagnosis. Teaching about a low-sodium diet is an inadequate intervention. An appointment with a healthcare provider, not a nutritionist, should be scheduled as soon as possible. There are insufficient data to support this emergency intervention (calling the paramedics). The client's elevated blood pressure needs to be evaluated by a healthcare provider and then medical therapy implemented. Although emotional stress can precipitate hypertension, physical causes should be ruled out first.