Sarikc540

1. A nurse is planning care for a client who has a prescription for a bowel- training program following a spinal cord injury. Which of the following actions should the nurse include in the plan of care? A. Encourage a maximum fluid intake of 1,500 ml per day. B. Increase the amount of refined grains in the client’s diet. C. Provide the client with a cold drink prior to defecation. D. Administer a rectalsuppository 30 minutes priorto scheduled defecation times . 2. A nurse in a pediatri...

1) A nurse is providing teaching to a client who has a severe form of stage II Lyme disease. Which of the following statements made by the client reflects an understanding of the teaching? a. “I willneed to take antibiotics for 1 year.” b. “My partner will need to take an antiviral medication.” c. “My joints ache because I have Lyme Disease.” d. “I bruise easily because I have Lyme Disease.” 2) A Nurse is caring for a client who is 4 hr postoperative following an open redu...

1.) A nurse is assessing a client who is receiving intravenous therapy. The nurse should identify which of the following findings as a manifestation of fluid volume excess? a. Decreased bowel sounds b. Distended neck veins c. Bilateral muscle weakness d. Thread pulse 2.) A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. Which of the following findings should indicate to the nurse that the treatment is effective? a. Absen...

1. A nurse is assessing a school-age child who has heart failure and is taking furosemide. Which of the following findings should the nurse identify as an indication thatthe medication is effective? a. An increase in venous pressure b. a decrease in peripheral edema c. a decrease in cardiac output d. an increase in potassium levels 2. A nurse is assessing an infant who has acute otitis media. Which of the following findings should the nurse expect (select all that apply) a. Increased...

1. A nurse in a prenatal clinic is caring for a group of clients. Which of the following clients should the nurse recommend for an interdisciplinary care conference? A client who is at 35 weeks of gestation and has a biophysical profile of 6 2. A nurse is preparing to discharge a client who has end stage heart failure. The clients partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take? Contact the case manager to discuss...

1. A nurse is admitting a client who has pulmonary tuberculosis. Which of the following transmission-based precautions should the nurse initiate? • Airborne • Rationale: Pulmonary tuberculosis is an infection that is transmitted by airborne dropletssmallerthan 5 micronsin diameter. Therefore, this client requires airborne precautions to prevent communicating this infection to others 2. A nurse in a mental health facility is preparing an educational program for a group of staff nurses...

1. A nurse is assessing a client who hasreceived an antibiotic. The nurse should identify which of the following findings as an indication of a possible allergic reaction to the medication? A. Bradycardia B. Headache C. Joint pain D. Hypotension 2. A nurse on a mental health unit is caring for a client who has schizophrenia and is experiencing auditory hallucinations telling them to hurt others. The client is refusing to take anti-psychotic medication. Which of the following responses sh...

1) A nurse is providing teaching to a client who has a severe form of stage II Lyme disease. Which of the following statements made by the client reflects an understanding of the teaching? a. “I will need to take antibiotics for 1 year.” b. “My partner will need to take an antiviral medication.” c. “My joints ache because I have Lyme Disease.” d. “I bruise easily because I have Lyme Disease.” 2) A Nurse is caring for a client who is 4 hr postoperative following an open red...

1. A nurse in a long-term care facility is assisting with an inservice for newly hired assistive personnel about legal issues within the facility. WhichofIthe following should the nurse include as an example ofIassault? ANS: Informing a client the nurse is going to administer an injection even though the client refuses . 2. A nurse is collecting data from who is severe pain. Which ofIthe following questions should the nurse ask first? ANS: "Where is your pain located?" 3. A nurse is ...

1. A nurse is reviewing the techniques for transferring a client from a bed to a chair with a group of assistive personnel (AP). Which of the following instructions should the nurse include? ANS: Use lower-body strength RATIONALE: The nurse should instruct the AP to use lower-body strength when lifting a client to reduce stress on the back 2. A nurse is participating in a quality improvement study about the effectiveness of client pain management in the unit. Which of the following strate...

1. A nurse in a long term care facility notices a client who has alzheimers disease standing at the exit doors at the end of the hallway. The clients appears to be anxious and agitated. Which of the following actions should the nurse take? Escort the client to a quiet area on the nursing unit 2. A nurse is assisting with the plan of care for a client who has a continent urinary division. Which of the following interventions should the nurse plan to implement to facilitate urinary eliminatio...

1. A nurse is caring for a client who has a recent diagnosis of a terminal illness. The nurse should identify which of the following as an indication of hopelessness? a. The client wants to talk about the diagnosis with nursing staff b. The client has a decreased energy level c. The client makes funeral arrangements d. The client requests a second opinion 2. A nurse is preparing to collect data on a preschooler. Which of the following behaviors by the child indicates that he is ready to c...

1. When administering the drug senna to a patient, a health care provider must inform the patient of which of the following a. This drug is intended to lower blood pressure and is best used in combination with other antihypertensives b. This drug is not intended for long term use c. The patient must limit his/her fiber intake d. Advise patient to change positions slowly to limit the risk of orthostatic hypotension 2. When giving digoxin (Lanoxin) to a patient, the health care provider no...

1. A nurse is caring for a client who expresses a desire to lose weight. Which of the following actions should the nurse take first? a. Recommend checking weight once weekly. b. Obtain a 24-hr dietary recall. c. Assist with creating an exercise plan. d. Initiate a plan for diet modification. 2. A nurse is teaching about nutritional requirements for a client who is starting a vegetarian diet. Which of the following information should the nurse include in the teaching? a. Consume high-fat...

Question 1: A nurse Is providing dietary teaching about prevention of neural tube defects in the fetus to a client who is pregnant. Which of the following nutrients should the nurse recommend? ● Calcium ● Folate ● Vitamin B12 ● Magnesium Question 2: A nurse is caring for a client who had a stroke and has manifestations of dysphagia. Which of the following interventions should the nurse take? ● Tilt the clients head backward to facilitate swallowing. ● Use liquids to clear fo...

A nurse is contributing to the plan of care for an older adult client who is postoperative following a right hip arthroplasty. Which of the following interventions should the nurse include in the plan? - Maintain abduction of the right hip. A nurse is caring for a client who has heart failure and respiratory arrest. Which of the following actions should the nurse take first? - Feel for a carotid pulse. A nurse is caring for a client scheduled for coronary artery bypass grafting who reports ...

A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. Which of the following instructions should the nurse include in the teaching? 1) Take temperature once a day. 2) Wash the armpits and genitals with a gentle cleanser daily. 3) Change the litter boxes while wearing gloves. 4) Wash dishes in warm water. A nurse is caring for a client who is postoperative following a tracheostomy, and has copious and tenacious secretions. Which of the following is an a...

A nurse on a medical-surgical unit is admitting a client. Which of the following information should the nurse document in the client’s record first? Assessment A nurse is witnessing a client sign an informed consent form for surgery. Which of the following describes what the nurse is affirming by this action? The signature on the preoperative consent form is the client’s A nurse on a medical-surgical unit is washing her hands prior to assisting with a surgical procedure. Which of the ...

1. A nurse is reinforcing information with a client who wishes to complete their advance directives. Which of the following statements should the nurse make? a) “You must have advance directives in place in order to refuse recommended treatment.” b) “An attorney is needed in order for you to name a designee in your health care proxy.” c) “You can decline to have certain medical procedures performed in your living will.” d) “A living will can be an oral statement that you agr...