Practice 2023 B
A nurse is planning to delegate client care
tasks to an assistive personnel (AP). Which of
the following tasks should the nurse plan to
delegate to the AP?
A. Provide instructions about client care to a
family member over the telephone.
B. Determine if the PRN pain medication
administered 30 min ago has helped.
C. Perform gastrostomy feedings through a
client's established gastrostomy tube.
,D. Teach a client how to measure their own
blood pressure. - ANSWER-Perform
gastrostomy feedings through a client's
established gastrostomy tube.
The nurse should delegate providing
gastrostomy feedings through the client's
established gastrostomy tube to an AP
because this task is within the AP's range of
function.
A nurse working on an inpatient mental
health unit is caring for a client who has
bipolar disorder and is experiencing mania.
Which of the following interventions should
the nurse recommend including in the plan of
care to ensure safe client care environment?
,A. Observe the client every 15 min.
B. Monitor the client for 30 min following
meals.
C. Encourage the client to participate in
group activities.
D. Provide the client with a brightly lit
environment. - ANSWER-Observe the client
every 15 min.
The nurse should observe the client who is
experiencing mania every 15 minutes.
Frequent observation allows the nurse to
identify behaviors that need redirection and
to protect the safety of the client and others.
A nurse on a medical-surgical unit is caring
for a client prior to a surgical procedure.
, Which of the following findings should
indicate to the nurse that the client has the
ability to sign the informed consent? -
ANSWER-The client is able to accurately
describe the upcoming procedure.
The ability of the client to accurately describe
the upcoming procedure indicates that the
provider adequately informed the client and
that the client is able to sign the informed
consent form.
A community health nurse is assisting with
the development of a disaster management
plan. The nurse should include which of the
following nursing responsibilities in the
disaster response stage of the plan? -