Thompson12

Ans: 2, 1, 4, 3 An irritable infant with fever and petechiae should be further assessed for other signs of meningitis. The client with the head wound needs additional history taking and assessment for intracranial pressure. The client with moderate abdominal pain is in discomfort, but her condition is not unstable at this point. For the ankle injury, medical evaluation could be delayed up to 24 to 48 hours if necessary, but the client should receive the appropriate first aid. Focus: Priorit...

2. Call the HCP stat 3. Check the apical pulse 4. Check the blood pressure 3. Check the apical pulse A DNR order requires the nurse to withhold resuscitation in the event of a cardiac or respiratory arrest. If an event occurs, the nurse should assess for breathing and check the central or apical pulse. After performing these actions, the nurse should call the HCP to confirm the death. The charge nurse on a medical unit assignments for the nursing team composed of a registered nurse (RN)...

c) The nurse expert witness in a case describes two methods of providing the intervention in question. (There may well be more than one way to provide an intervention and still meet the standard of care. This is the basis of the two schools of thought doctrine.) Which situation supports the charge of malpractice against a professional nurse? A failure on the part of the nurse to exercise reasonable and prudent care in treating a patient (Malpractice is based on the nurse breaching the sta...

A client who was placed in restraints appears in the hallway an hour later and states."I'M Houdini... I can get out of anything. There could be trouble now." Which of the following is the BEST response to the client? # (12) 1. "How are you feeling now?" 2. "How did you manage to get out of the restraints?" 3. Say nothing but signal to other staff that assistance is needed. 4. "What kind of trouble are you thinking about?" 4 An adult client is admitted with back pain and found t...

a blood splash into the nurse's eyes; Hepatitis B virus is spread through contact with blood, body fluids contaminated with blood, and such body fluids as cerebrospinal, pleural, peritoneal, and synovial fluids; semen; and vaginal secretions. The risk of transmission of hepatitis B through feces is low. Touching the client without gloves is acceptable when there is no danger of contact with blood or body fluids. Recapping a used needle is a common source of needlestick injuries; needles sh...

3 The registered nurse is caring for multiple clients on a busy surgical unit and should delegate which action to the unlicensed assistive personnel? 1. Assist client, post hip fracture repair, to the bathroom 2. Check the appearance of client's wound 3. If client tolerates oral liquids, discontinue nasogastric tube 4. Offer orange juice to client if bedside glucose reading is <70 mg/dL (3.9 mmol/L) 1 Which statements related to ethical nursing practices are correct? Select all that ...

After the emergency department (ED) triage nurse has assessed these patients, which patient should the nurse have the ED physician evaluate first? The 37-year-old who is complaining of left-sided chest pain and dyspnea The 45-year-old who has fallen from a ladder and is complaining of back pain The 52-year-old with a history of kidney stones who has severe left flank pain The 68-year-old who has a blood pressure of 170/98 mm Hg and a nosebleed A patient with left-sided chest pain and dyspn...

delivery? Select all that apply. Correct1 Collaboration Incorrect2 Care planning 3 Communication Correct4 Clinical judgment Correct5 Cultural competency The Synergy Model describes eight nurse competencies, which include collaboration, clinical judgment, advocacy and moral agency, caring practices, facilitation of learning, systems thinking, response to diversity (cultural competency), and clinical inquiry. Care planning and communication are skills that every nurse should demonstr...

C Changing dressings that become wet or soiled E Using soap and water to remove drainage, dried secretions, or excess perspiration from a client's skin F Emptying urinary drainage systems (Foley catheter drainage) on each shift unless prescribed otherwise by a physician Which of the following actions are means of maintaining medical asepsis to reduce and prevent the spread of microorganisms? Select all that apply. A Practicing hand hygiene E Routinely cleaning the hospital environment ...

Which of the following events would require a nurse to complete and file an incident report? When a visitor suddenly becomes weak and dizzy, the nurse checks the visitor's blood pressure and takes the visitor to the emergency department for treatment. A nurse, charting the administration of medications to an assigned client at 9 pm, notes that atenolol (Tenormin) was prescribed to be administered at 9 am instead of 9 pm. The nurse checks the client's vital signs, completes an incident re...