With Complete Solutions
A charge nurse observes a nurse administer intermittent tube
feeding via an NG tube to a client. Which of the following
actions should prompt the charge nurse to intervene?
A. The nurse initiates the feeding after aspirating 50 mL of
gastric residual.
B. The nurse irrigates the NG tube with tap water after feeding.
C. The nurse administers the feeding through a syringe barrel by
gravity.
D. The nurse allows the client to rest in a supine position during
feeding. Correct Answers The nurse allows the client to rest in
a supine position during feeding.
The nurse should elevate the head of the bed to a minimum of
30° to prevent aspiration from reflux during feedings.
A nurse in a long-term care facility enters the day room and
finds the window curtains on fire. Clients are panicking and the
room is filling with smoke. Indicate the emergency actions the
nurse must take. (Move the steps into the box on the right,
placing them in the order of performance. Use all the steps.)
Correct Answers - Remove the clients from the room
- Activate the fire alarm
- Close the door
- Extinguish the fire
A nurse in a provider's office returns a telephone call by the end
of the day, as promised, to a client who is worried about the
, outcome of a laboratory test. The nurse is demonstrating which
of the following ethical principles?
A. Autonomy
B. Justice
C. Fidelity
D. Nonmaleficence Correct Answers Fidelity
The nurse demonstrates the ethical principle of fidelity by
keeping a promise.
A nurse is assessing a client following the application of an
aquathermia pad. Which of the following is the first indication
to the nurse that the client is experiencing a superficial burn
injury to the application site?
A. Blistering
B. Erythema
C. Eschar
D. Absence of pain Correct Answers B. Erythema
Erythema is an indication that the client has experienced a
superficial burn with damage limited to the epidermis. Other
manifestations include edema, pain, and increased sensitivity to
heat.
A nurse is assessing a client who is experiencing prostatic
hypertrophy. Which of the following findings associated with
urinary retention should the nurse expect? (Select all that apply.)
Correct Answers - Report of feeling pressure
- Tenderness over the symphysis pubis