2., 3. Incorrect: Discussing the assignment with another LPN is delaying the client's needed intervention. Secondly, staff will be far too busy to watch television or listen to the radio with all the activity occurring hospital wide. Incorrect: The RN is responsible for developing the plan of care which would include necessary referrals. The client is considered unstable until assessed by the nurse. d. Identity vs role confusion, b. Assigning tasks to an AP (delegation is considered indirect care), 13. These are appropriate tasks for an UAP to complete. 4. Some general guidelines are necessary, with input from clients and family to individualize any special requests with assistance from the facility. a. Demonstrate the use of clinical reasoning in prioritizing and evaluating the delivery of client care. Decreased RBC production 4. 2. Increased insulin production Assessing this client and titrating the diltiazem requires the skills of an RN. Incorrect: Passive ROM is performed with paralysis and can be delegated to the UAP. It results in an exchange of ideas, problem solving expression of feelings, decision making, and personal growth). b. 4. 3. What task would be best to assign to the LPN/LVN? These irregularly shaped cells can get stuck in small blood vessels, which can slow or block blood flow and oxygen to parts of the body. Assist a client to ambulate using a gait belt. b. I'm so sorry to hear about this A client with epilepsy reporting an odd smell in the room. Which client would be appropriate for the RN to assign to the LPN? c. Behaving defensively e. Throw rugs, d. I will take my medications at the first sign of an attack, 41. It is within the LPNs scope of practice to administer antibiotics. If the decimal point is missed in this situation, the client could receive 5 mg instead of the intended dose of 0.5 mg of risperidone. Remind the client to tell the nurse when he has to urinate 3. d. I will wear synthetic clothing and woolen socks when using my oxygen, c. Check to see if the suction equipment is working, 74. Which of the following actions should this nurse take? (a) HCN(aq)+H2O(l)H3O+(aq)+CN(aq);K=4.91010\mathrm{HCN}(a q)+\mathrm{H}_2 \mathrm{O}(l) \longrightarrow \mathrm{H}_3 \mathrm{O}^{+}(a q)+\mathrm{CN}^{-}(a q); K=4.9 \times 10^{-10}HCN(aq)+H2O(l)H3O+(aq)+CN(aq);K=4.91010 A nurse wants to find out a better way to perform oral care on unresponsive clients. Nurse-patient assignments help coordinate daily unit activities, matching nurses with patients to meet unit and patient needs for a specific length of time. d. I will take my medications at the first sign of an attack, d. To identify delayed gastric emptying (the nurse should measure the amount of unabsorbed formula from the previous feeding to identify delayed gastric emptying; if it is delayed the nurse should avoid overfeeding the client and causing gastric distention), 42. a. b. I will keep the fluorescent ceiling light on in my room at night These areas require the expertise of an RN and would not be appropriate for an LPN/LVN. d. Voided 30 mL frequently, 48. Once the client is stable, the UAP could perform this task. The third client that should be sent back for treatment is the female client stating she has been raped. 4. Which of the following physiological responses to prolonged immobility should the nurse expect? d. Water heater temp 54.4 C (130 F) & 5. a. Encourage the client to be more cooperative. The first client, who is 1 day postoperative following a partial bowel resection, requires a dressing change, total parenteral nutrition administration and reports a pain level of 6 on a scale of 0 to 10. Remind the client that a signed informed consent form is a legally binding document Which of the following clients should the charge nurse assign to a licensed practical nurse (LPN)? A nurse identifies a pressure ulcer after a client had a long, extensive recovery following a surgical procedure. This service began with the client's admission to the hospital Although this is a correct thing to inform the client, this teaching should be done by the RN and not delegated to the UAP. Correct: Did you notice the hint? Which of the following actions should the nurse take? A copy of select parts of the medical recording, according to facility policy, is another form of communication that will support continuity of care. 1. Client with arthralgia who is receiving regularly scheduled pain medications and has warm compresses prescribed. Incorrect: A UAP may not remove and change surgical dressings, which would involve assessment and further education. Therefore, the nurse with Labor and Delivery experience would be the most appropriate one to assign to care for this client who has postpartum preeclampsia. Incorrect: Although this nurse is working on the postpartum unit, did you recognize the length of experience? This client is at a high risk of infection. c. Foot 4., & 5. (Select all that apply.) d. Put the side rails up and tell the client to call the nurse before voiding, d. Two nurses using a friction-reducing device (reduces the risk of injury to the nurses and to the client; nurses can use a draw sheet as a friction-reducing device), 38. Inform the client of the need to avoid irritants such as carbonated beverages. c. Blood-tinged urine Which of the following instructions should the nurse include? a. This is not a situation that requires the LPN to notify the primary healthcare provider. Which of the following client statements indicates an understanding of the procedure? A nurse who is breastfeeding her 4 month old. c. I will place an area rug at the entry of my bathroom Correct: The only procedure listed that is within the LPN/LVN's practice range is changing the colostomy bag. Change the subject when the client behaves defiantly Channel The client with chronic emphysema has expected shortness of breath. c. Depression 3. c. One nurse lifting the client's legs as the client uses a trapeze bar This service focuses on teaching the primary caregiver to meet the client's needs Write N next to the nonessential clauses and E next to the essential clauses. 1. The charge nurse must assign the clients to a team consisting of RNs, LPN/LVNs, and one CNA. Respite care allows the primary caregiver time away from day-to-day care responsibilities Denial Assist client to brush and floss teeth. A client receives a wrong medication. b. A 10 year old school-age child would also be more cooperative, making it easier for the LPN to interact with that client. 4. 3. Client diagnosed with a hemorrhagic stroke 1 week ago, who currently has a blood pressure of 170/96. Which of the following tasks should the nurse delegate to unlicensed assistive personnel (UAP)? Which of the following should the nurse include as a criterion for applying restraints? M2.4 Making Client Care Assignments - GECC As the RN charge nurse, you are preparing to make assignments for the oncoming shift on the medical-surgical unit. d. Social conversation, a. 5. Incorrect: The wash cloth is placed in the sink to prevent the dentures from breaking if they are dropped. Which of the following statements should the nurse identify as an indication that the client needs further teaching? Provide a between meal supplement to the client. Discuss the competency of the surgeon Select all that apply So, this client who is receiving PRN pain medication is certainly someone that the LPN could be assigned to. 5. A nurse is caring for a client in a long-term facility who is receiving enteral feedings via an NG tube. Well, do you see the q.d.? 3. I am feeling much better since my discharge from the hospital and I think my kidneys are working again." Assuming that dissolved reactants and products are present at 1 M concentrations, which of the following reactions are nonspontaneous in the forward direction? A nurse is working with an AP while caring for a surgical client who is 1 day postoperative. 2. Hormone replacement does not affect the immune system and, therefore, this nurse is not at risk for infection from CMV exposure. Identify and assess each incoming client. e. an open perineal wound, 92. d. Perception Point out inconsistences in the client's behavior (a nurse using confrontation helps the client become aware of inconsistencies in his feelings, attitudes, beliefs, and behaviors. Soaking the dentures in hot water Incorrect: This is not completely practical for everyone. 1. Incorrect: What seems to be going on with this client? 2. Incorrect: The nurse is assuming that the client's quarrelsome behavior is normal for this client. b. Summarization 3. Incorrect: It is out of the UAP's scope of practice to administer medication. A nurse is caring for a client who has a mental health disorder. A charge nurse is planning client activities for the day. Which prescription should the nurse question and have corrected? (Select all that apply.). Even though this nurse just had a baby, there is no risk of her transmitting this virus to her child. 6. This perceived lack of control can create distrust and frustration among personnel, ultimately impacting client care. Incorrect: Emergency room nurses deal with life threatening emergencies but are not specialized in the care of clients with preeclampsia. A nurse is caring for a client who has emphysema and has difficulty with mobility. What task would be best to assign to the LPN/LVN? This is a diabetic clinic. What is the appropriate assignment? A nurse is providing discharge teaching about clean intermittent self-catheterization for a client who has a benign prostatic hyperplasia. Which clients should be assigned to the CNA? a. a. 3. Prepare a list of clients who could quickly be discharged or transferred. All these clients have a GI problem. Have another nurse finish preparing the medications A cardiac step down unit has requested float staff because of multiple impending admissions. The nurse considers various ideas submitted by team members. It is the nurse's responsibility to communicate the client's condition and care plan to the receiving facility nurse in order to support continuity of care. Did you think dehydration and fluid volume deficit? A family member requests that the nurse apply restraints. Correct: Traction should never be relieved without a primary healthcare provider's prescription. b. Right forearm The nurse should do this when repositioning is needed. Incorrect: Informing is the same thing as teaching. b. with this question, the nurse is using which of the following communication techniques? 4. Thus they are kept in charge of basic patient care like administration of tests, medicines and proper provision of the required treatment. A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding herself using adaptive devices. In which harmonic number n is the string vibrating? d. Clients are placed on artificial life support before organ and tissue donation can occur, a. I'll sit with my knees lower than my hips (client should sit with knees slightly higher than their hips to prevent injury), 24. c. Respite care helps relieve pain and promote comfort The expected standard of care was strict bed rest), 96. Which tasks should the charge nurse complete at the end of the shift before leaving for the day? b. 4. a. Clarification d. Assault, b. Additional data includes pulse 100/min, RR 24/min, BP 124/76 mm Hg, and temp 36.8C (98.2 F). 2. When a family member asks how respite care can help, which of the following responses should the nurse provide? d. Move to the opposite side of the pack and open the fourth flap, 54. A nurse is filling out an incident report after finding a client lying on the floor. Which of the following health care professionals is responsible for obtaining informed consent from the client for the procedure? A nurse receives a client care assignment from the charge nurse that he believes is unfair. Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. 3. 1. d. Use attentive listening with the client, d. Water heater temp 54.4 C (130 F) (no higher than 49 or 120) The client post PEG placement is stable. 1. The RN with 2 weeks' experience on the postpartum unit. The nurse should not assume that the UAP just did not do their job, but needs to ascertain the reason for not feeding the client. c. Assist the client to the floor and begin mouth-to-mouth A charge nurse is observing a group of newly licensed nurses. Collecting I & O totals for unit clients at the end of shift. Which pediatric client care assignment is most appropriate for the charge nurse to delegate to the LPN/LVN? C-section planning discharge, postpartum infection, mastectomy. This invasive procedure results in some edema to the vessel used for the procedure but assessing only one pedal pulse does not provide sufficient data to verify a complication. A nurse is caring for a client who is immobile. Incorrect: This response overlooks a potentially severe problem. A charge nurse is making client care assignments. 4. Incorrect: Volunteering to take a client would add more work to the charge nurse when this might not be necessary. Which of the following tasks should the nurse delegate to assistive personnel (AP)? 2. 2. The nurse should not be assigned to provide care if impairment is suspected. d. Routine acquisition of a urine specimen The nurse cannot assign assessment and evaluation of the nursing process to the UAP. Stand directly in front of the client So what is wrong with option #1? A nurse receives a client care assignment from the charge nurse that he believes is unfair. A nurse is caring for a client who has a hip fracture that requires surgical repair. 2. Delegate 2 nurses to work with the client. Select all that apply. a. Thus, the tasks involve successful management of the charge nurse's responsibilities. When staff do not feel vested in any new process, there is a sense of underappreciation. Incorrect: This is appropriate because this position will improve gas exchange and breathing for a client after thoracic surgery. d. When asking if the client took his medications this morning, 82. 4. Perform the Heimlich maneuver Drag and Drop the items from one box to the other. the nurse responds: "It must be very frustrating to encounter this kind of attitude." You would be jeopardizing the limb of this client to take the time to do discharge teaching for the client waiting to go home. d. Droplet, d. Bend at the knees when picking up an object, 98. c. Environment _____The house that we lived in for nine years has been sold. Which of the following activities should the nurse perform in this zone? Determining the client's length of stay 5. The infusion rate has stopped but the tubing is not kinked b. It's unfortunate that I have to be in the hospital for this treatment e. Suctioning a client's new tracheostomy tube, 93. However, it is on the "Do Not Use" list of abbreviations because it can be confused with morphine sulfate (MSO4). c. To determine the client's electrolyte balance c. Make sure the client has an intake of 2,000-3,000 mL of fluid/day a. Hypotension This center functions as 'information central', where all plans or activities are coordinated and determined by those personnel. 1. They are able to manage tasks related to basic care. Removing the client's dentures A client on a surgical unit frequently quarrels with the staff. a. Auscultate breath should at least ever 2 hr Make referrals to community services. Incorrect: Although this action appears to be opening lines of communication, the nurse manager is actually fostering animosity in a situation where the outcome is already predetermined.
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