Assigning this nurse to the newborn with CMV would put her unborn baby at high risk for life-long defects and even death. 3. Correct: Positive feedback is an effective communication tool that improves the workplace environment and encourages individual achievement, particularly in challenging situations. It is within the LPNs scope of practice to administer antibiotics. Showing disapproval Correct: It would be best to explore the reason the RN thinks the assignment is too heavy. 208 The surgeon initially prescribes a clear liquid diet. 3. The client is reporting anxiety, discomfort, and a feeling of bloating. The client is getting better. b. Incorrect: Passive ROM is performed with paralysis and can be delegated to the UAP. d. Message, 67. b. I will come back later and we can talk The nurse asks the client, "Are you feeling anxious about the results of your colonoscopy?" Review the action of insulin therapy An adult (18 years or older) can create an advanced directive. Which of the following responses should the nurse make? c. Respite care helps relieve pain and promote comfort Which of the following interventions should the nurse use to help maintain the integrity of the client's skin? Client #1 has COPD, and, although complaining of shortness of breath, that is not unusual for clients with this diagnosis. Incorrect: The nurse may trust the UAP; however, the nurse has not been able to determine the competency of the new staff member. Incorrect: A lumbar puncture involves removing cerebrospinal fluid from the subarachnoid space to diagnose specific diseases or the presence of bacteria. 1. 1. Include any relevant statements the client made about the ulcer The below statement corresponds to a numbered sentence in the passage. d. Reduced blood viscosity, a. Auscultating heart sounds 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. Request a prescription for a medication to ease the client's anxiety 1. Which of the following statements should the preceptor make? Following a passenger train derailment, local hospitals are notified to activate disaster protocols on all floors. Client admitted 48 hours ago with an ischemic stroke and a history of seizures, who has been prescribed clonazepam. Incorrect: A client who has a spinal cord injury and is in rehabilitation is still alert and able to make decisions. Incorrect: When a unit is very busy, the nurse should rely on the UAP if the person is competent to perform the tasks. a. b. A nurse on a medical unit is caring for a client who suddenly becomes confused and drowsy. (Select all that apply.) Which client should be assigned to a nurse who was pulled from a medical unit to the neurological unit? The RN who has worked in Labor and Delivery would have knowledge and experience caring for clients with preeclampsia. What is the best first action for the nurse to take in order to achieve this goal? An experienced nurse would be assigned to this unstable client due to the possibility of a reoccurring hemorrhagic stroke resulting from the client's hypertension. 4. Which tasks would be appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)? There are potential problems in Options #1, 2, 3, and 4 and should be questioned and corrected. 1. Relax her abdominal muscles when she lifts an object Client who received blunt abdominal trauma in a motor vehicle accident who is reporting a worsening of the abdominal pain. which of the following actions should the nurse perform? Incorrect: The nurse manager is aware that health care facilities often face both political and financial issues that impact staff and clients simultaneously. Correct: Cytomegalovirus is a viral infection that can be devastating to a fetus, especially in the first trimester. d. Determine if the client uses hearing aids, b. 2. b. 1. Incorrect: Volunteering to take a client would add more work to the charge nurse when this might not be necessary. A home health nurse is conducting a home safety assessment for an older adult client. 4. Point out inconsistences in the client's behavior Evaluate pain relief after narcotic administration. c. Notifying the provider of physical exam findings 3. The client will need to be assessed, but there is no specific indication the respiratory status is presently compromised. Occupational therapist (an occupational therapist assists clients who have physical challenges to use adaptive devices and strategies to help with self-care activities such as feeding). The third client would be the one needing a dressing change. c. Leave a nightlight on in the client's room A nurse in a long-term care facility is observing an AP changing the linen for a client who has fecal incontinence. a. An increased temperature will have a direct effect on the brain's metabolism and function. Increased insulin production Which of the following instructions should the nurse include? Accept assignment, documenting personal concerns regarding work conditions. Client assignments are based on client acuity and nurses do not necessarily have the same number of clients. Elevating the head of the bed 30- 40 for the client post thoracotomy 4. b. 3. Correct: The medical nurse can be assigned to this client. 3. The client with cystitis is stable and has a predictable outcome. b. Incorrect: Informing is the same thing as teaching. a. e. Throw rugs, d. I will take my medications at the first sign of an attack, 41. The client receives home health care and spends most of his day in a reclining chair. This client is eating a simple carb snack, but the nurse needs to check the client's blood glucose level to see if the snack has helped. The nurse has been assigned four clients. Once the client is stable, the UAP could perform this task. 3. a. Gloves A charge nurse is making client care assignments. 7. The nurse received a client following surgery 8 hours ago. (Select all that apply) The nurse chooses to confront the client. d. I will wear synthetic clothing and woolen socks when using my oxygen, c. Check to see if the suction equipment is working, 74. 3. Because positioning on a bedpan requires rolling of the client, an RN should be assigned to assess the insertion site and monitor for the presence of bleeding. What was the rationale for this plan? Incorrect: Emergency room nurses deal with life threatening emergencies but are not specialized in the care of clients with preeclampsia. Obtain a bedside commode for the client's use Client admitted 24 hours ago with a diagnosis of a stroke, who is now reporting a headache that intensifies when moving in the bed. The LPN/LVN can reinforce teaching. Incorrect: Hanging a new bag of TPN is parenteral therapy requiring a central line. 4. 2. A nurse is caring for a client within the intimate zone of the client's personal space. A nurse is caring for a client who is postoperative. Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. I will begin 48 hr before the client's discharge 1., 2., 3., & 4. The nurse is responsible for the assessment of all vital signs of post-op clients. d. Assault, b. Which task would be appropriate for the nurse to assign to the unlicensed assistive personnel (UAP)? Offer to take one of the clients. Therefore, this client needs the advanced assessment skills of the RN and should not be assigned to the LPN. TRAINED TO BE RELIEF CHARGE NURSE FOR THE UNIT, COMPLETE PATIENT ASSIGNMENTS, CUSTOMER SERVICE AND PROBLEM-SOLVING PROFICIENCY JUNE 2021 - JUNE 2022 STAFF RN - 3C GI MED SURG PROFICIENT IN . d. Wait to discuss the behavior in the presence of others, a. Changing the subject b. Donation costs are the responsibility of the donor's family and estate Additional data includes pulse 100/min, RR 24/min, BP 124/76 mm Hg, and temp 36.8C (98.2 F). 3. There is a possibility that a hypothermia blanket may be prescribed. d. They disclose more personal information, a. d. Remove and reinsert the NG tube, a. 2. d. Apply antiembolic stockings, d. I will place a bath seat in my shower to use when I bathe, 44. Assist a client to ambulate using a gait belt. 2) Assist a client to ambulate using a gait belt. d. I'll use each cleansing wipe twice, d. I decline this opportunity at this time (assertive because it contains an "I" statement and it is clear and firm), 52. 3. This client should report an improved respiratory, not shortness of breath. A nurse is caring for a client who has had an allogenic hematopoietic stem-cell transplant. & 5. To focus on effective learning with this client, which of the following interventions should the nurse use? A nurse instructs a female client about collecting a midstream urine sample. Correct: The clue that should be picked up on here is that the client is now reporting that the cast has become too tight. Which of the following actions should the nurse include in the plan? This protein is released by cells in the stomach. Education c. I'll wear low heeled shoes from now on Simply accept the assignment since overtime is mandatory. b. Summarization Correct. Incorrect: A colostomy client with diarrhea will have a lot of drainage requiring frequent emptying of the colostomy bag. 1., 2., 4., & 5. a. 2. Notify the primary healthcare provider. Making patient assignments is an important charge nurse role that lacks theoretical support and practical guidelines. Incorrect: The client does need to have food; however, there is another action that should be performed first. Licenced practical nurses are a little less educated than registered nurses. 4. 3. The nurse can accept the assignment, documenting your personal concerns regarding working conditions in which management decides the legitimacy of employee's personal concerns. Client scheduled for a dressing change to foot ulcer. b. The first client who needs treatment is the one with multiple injuries from a motor vehicle accident. Encourage clients and families to develop mutually appropriate visitation times. 2. The last client would be the one needing dietary education. A nurse working on the pediatric oncology unit is beginning the shift and has received report which included some new laboratory data for the clients. c. Contact It's just not the right time for me to do this This would be out of the UAP's scope of practice. The responsibility of the nurse manager is to implement change in a positive manner, while assisting staff adaptation even to unpopular modifications. c. Take the client to the bathroom every 2 hr Two nurses lifting the client under the shoulders The first vital sign check was performed by the nurse. Disconnect client's nasogastric (NG) tube suction to allow ambulation. Providing a passive response d. Offering sympathy, d. Test the pH of gastric aspirate (nurse should verify position of tube, testing pH is acceptable method between x-ray confirmations), 85. A goal for this client is to use proper body mechanics at all times. This is an appropriate and safe action for the unlicensed nursing assistant to do. Teach the UAP to change surgical dressings. b. a. a. Symbolic communication All these clients have a GI problem. c. Palpating for pedal edema What actions should a nurse take to provide continuity of care when discharging a client diagnosed with hemiparesis to a long-term care facility for rehabilitation? a. 1. Incorrect: If alcohol or drug dependency is suspected, confrontation will result in hostility and denial. Each ROM movement should be repeated 5 times during the session. A nurse accidentally sticks her hand with a syringe needle after administering an IM injection to a client. c. Paraphrasing Which of the following statements by the student indicates understanding of the discussion? Total abdominal hysterectomy, bladder suspension with A&P repair, client with breast reduction. The client post PEG placement is stable. Client to receive dietary education. A nurse is assessing a client who is experiencing prostatic hypertrophy. c. Make sure the client has an intake of 2,000-3,000 mL of fluid/day a. Feed a client that had a stroke 3 months ago. Two hours after other trays were picked up from the rooms, the nurse notes that the client's untouched tray is still at the bedside. Which of the following types of torts has the nurse committed? The charge nurse on the postpartum unit is making assignments. c. I'll bear weight on my ankle for 10 minutes every hour Relief of urinary retention A nurse is prioritizing care for two clients at the start of the shift. a. Auscultate breath should at least ever 2 hr 4. The women's health charge nurse is making assignments for the next shift. b. 2. 1. 3. A client receives a wrong medication. It involves people who are constantly changing-their conditions improve and deteriorate, they're admitted and discharged, and their nursing needs can change in an instant. 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. Incorrect: This option would create total chaos, interrupting sleep patterns and staffing schedules. The second client that should be given a treatment room is the elderly client who fell and fractured the left femoral neck. 1. Currently, your census is 11, with one empty bed. Incorrect: Most adults have already been exposed to the virus and are not at risk for adverse effects of the infection. Client reporting epigastric pain and nausea after eating. The client asks the nurse, "Why do I need that? Which of the following tasks should the nurse delegate to assistive personnel (AP)? 3. d. Swab an area of skin away from the wound to identify the usual flora, a. Elicit info from the client (obtaining info from the client is a component of orientation phase), 57. A nurse is preparing an education presentation about organ donation for a group of newly licensed nurses. A nurse removes an indwelling urinary catheter that an older client has had in place for 2 days. Call the client's provider PURPOSE AND SCOPE: Supports FMCNA's mission,vision, core values and customer service philosophy. The nurse voices his concern to the charge nurse. 4. 1. d. What have you done in the past to cope with this issue? Refuse the overtime assignment, being prepared for disciplinary action. Warm the feeding solution to the body temperature Incorrect: Atrial fibrillation places the client at risk for blood clots. c. Hold an object away from her body as she lifts it Incorrect: Dealing with a client's emotional state requires a formative evaluation to gauge readiness and requires the knowledge of the RN. A school-aged child with a fractured femur who is in balanced suspension traction. b. You get this vitamin from eating foods such as meat, poultry, shellfish, eggs, and dairy products. Assign more daily tasks to the UAP. Incorrect: The purpose of a cystogram is to examine the inside of the bladder to confirm the presence or absence of abnormalities, or even obtain a biopsy. Personal liability coverage is not mandatory, but you should consider purchasing your own coverage, 87. a. INCORRECT: Although the vascular status of the foot will need to be assessed, there is no indication if the debridement has been completed yet. Incorrect: The RN is responsible for collecting data. 3. Incorrect: It is out of the UAP's scope of practice to administer medication. Which of the following actions should the nurse take? 3. c. Blood-tinged urine A client with fibromyalgia reporting generalized pain of 7 out of 10. A nurse is creating a discharge plan. 3. 4. Discuss the competency of the surgeon Nothing life threatening. d. Talk with others who have info about the client, b. I can detect the presence of carbon monoxide by a metallic odor, 58. A nurse is caring for a client who has a wound infection. A Medical Power of Attorney is a type of Advance Directive that appoints a health care agent to make decisions on the client's behalf when the client is unable to do so. Feed the client after warming the food. Which nurse should be assigned to care for this client? 1. Incorrect: No, the monitoring is too specific for the med-surg nurse. a. A nurse is caring for a client whose partner asks to speak with the nurse. c. Shivering (shivering is a systemic response to cold therapy as the body attempts to promote heat production), 77. It is the primary healthcare provider's role to receive acceptance for transferring a client to another facility. 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. They are likely to wait for others to initiate conversation d. Have the client practice blood-glucose monitoring using a glucometer, d. When asking if the client took his medications this morning, 81. c. Contact the provider to question the dosage (when a nurse believes there is an error in a prescription, the nurse must question the provider). This is outside the scope of practice for the LPN/LVN. Which of the following statements should the nurse make? a. a. Bathtub with rails A nurse is admitting a client from a long-term care facility. During report, the nurse notes that the float nurse appears disheveled, flushed, and is trembling slightly while drinking coffee. b. However, each unit must have one designated representative to send to the command center, when requested, to receive and then relay, pertinent information back to the unit. Correct: A LPN should be able to care for a client with arthralgia who requires pain medication on a regular schedule and is receiving warm compresses. b. The critical care nurse is caring for a client with a head injury secondary to a motorcycle accident who, on morning rounds, is responsive to painful stimuli and assumes decorticate posturing. d. Services are centered in long-term care facilities, a. The nurse is using which level of communication at this time? Start MgSO4 at 3g/hr IV Report of feeling pressure Battery So what is wrong with option #1? Describe the types of machining operations that can be performed on a lathe. Correct: Advance directives do consist of two types of legal documents: Power of Attorney and a Living Will. c. Provide the client with a diet high in protein a. I wish I didn't have to attach the electrodes to my skin Could you try contacting a support group Empty the drainage bag at least every 8 hrb.) The nurse suggest that the family might need to respite care services. d. Transporting a cerebrospinal fluid specimen to the lab -Review a low-sodium diet for a client who has HTN d. Complete an incident report, 70. Drag and Drop the items from one box to the other. 4. A nurse is caring for a client who is discussing his post-traumatic stress disorder and states: "Everyone thinks you should be able to put it out of your mind. The nurse is reviewing some clients' prescriptions. b. The nurse should perform which of the following activities in this space? 1. 3. A nurse is discussing indications for urinary catheterization with a newly licensed nurse. c. Hallucinations at the onset of sleep a. Bathe a client who had an amputation 2 days ago Select all that apply. b. This situation is considered an external disaster which means the hospital will be expecting multiple victims. Charge nurses have integral roles in healthcare organizations. The charge nurse is preparing the patient care assignments for the day shift, assigning clients to a LPN/LVN and a certified nursing assistant (CNA). Right forearm 1. A newborn is admitted to the nursery with a diagnosis of rule out cytomegalovirus (CMV). c. They tend to use more verbal communication Client #5 -It is considered within the scope of practice for an LPN/LVN to monitor a transfusion of a blood product. 4. Make nursing assignments appropriate to the skill level . Teaching can be reinforced by the LPN/LVN, but they cannot perform the initial teaching. b. c. 214 Correct: First, you must recognize that this client has the signs and symptoms of postpartum preeclampsia. Correct: A thoracentesis is performed to remove fluid from the pleural cavity and improve the client's respiratory status. 3. This stage involves constructive efforts on the part of the group members Because the charge nurse observes and weighs . b. Urinary frequency for several days This stage is when testing occurs to identify boundaries of interpersonal behaviors Teaching is not in the role of the LPN and therefore, this client would need to be assigned to the RN, not the LPN, for the teaching needs of the client. A client with a fractured right humerus who reports the cast is too tight. Obtain a client's consent This referral would be appropriate. It's unfortunate that I have to be in the hospital for this treatment (TENS units are portable; they can be used at home), 45. Which of the following statements should the nurse identify as an indication that the client needs further instruction? Assist client to brush and floss teeth. Irrigate a client's ear canal. This client would be the priority based on the need for prompt recognition and treatment of the neutropenia and signs of infection present. Suggest splitting the shift with another nurse. 1 Everything will be okay d. I shouldn't advice you about what is ultimately a personal decision, b. Incorrect: This client does not have a predictable outcome. Which client would be appropriate for the RN to assign to the LPN? & 4. But the evidence-based care leaders are trained to help nurses through the proper process of evidence based research. c. I will make sure my visitors smoke outside d. Apply cornstarch to keep the skin dry, b. Wash the area of the puncture thoroughly with soap and water (the greatest risk to this client is injury from any bloodborne pathogens on the needle therefore the first action the nurse should take is to provide immediate first aid), 28.

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