ATI RN Fundamentals A nurse is admitting a client who has an abdominal wound with a large amount of purple tissue drainage. Which of the following types of transmission precautions should the nurse initiate? Protective environment Airborne precautions Droplet precautions Contact precautions - Contact precautions A nurse is caring for a client who is expressing anger about his diagnosis of colorectal cancer. Which of the following actions should the nurse take? -Discuss the risk factors for colon cancer. -Focus teaching on what the client will need to do in the future to manage his illness. -Provide the client with written information about the phases of loss & grief. -Reassure the client that this is an expected response to grief. - -
Reassure the client that this is an expected response to grief. A nurse is caring for a client who is postoperative following a knee arthroplasty & requires the use of thigh -length sequential compression sleeves. Which of the following actions should the nurse take? -Assist the client into a prone position -Place a sleeve over the top of each leg with the opening at the knee -Make sure two finger can fit under the sleeves -Set ankle pressure at 65 mmHg - -Make sure two finger can fit under the sleeves A nurse is preparing to apply a dressing for a client who has a stage 2 pressure injury. Which of the following types of dressings should the nurse use? Alienate Gauze Transparent Hydrocolloid - Hydrocolloid A nurse is preparing an education program for the staff about advocacy. Which of the following information should the nurse include? -Advocacy ensures clients' safety, health, & rights. -Advocacy series that nurses are able to explain their own actions. -Advocacy ensures that nurses follow through on their promises to clients. -Advocacy ensures fairness in client care delivery and use of resources. - Advocacy ensures clients' safety, health, & rights. A nurse is admitting a new client. Which of the following actions should the nurse take while performing medication reconciliation? -Verify the client's name on their identification bracelet with the medication administration record -Call the pharmacy to determine whether the client's medications are available -Compare the clients home medications with the provider's prescriptions -Place the client's home medication bottles in a secure location - Compare the clients home medications with the provider's prescriptions A nurse is assessing an older adult client's risk for falls. Which of the following assessments should the nurse use to identify the client's safety need? (Select all that apply) -Lacrimal apparatus -Pupil clarity -Appearance of bulbar conjunctivae -Visual fields -Visual acuity - Pupil clarity Visual fields Visual acuity A nurse is providing discharge instructions to a client who will be using a walker. Which of the following client statements indicates an understanding of the teaching? -"I can place an extension cord across my living room to plug in my television." -"I will hire someone to trim the tree that hangs low over the stairs of my front porch." -"I will place my alarm clock on my bedroom dresser across the room." -"I will replace the old throw rug in my kitchen with a new one." - -
"I will hire someone to trim the tree that hangs low over the stairs of my front porch." A nurse is reviewing a client's fluid & electrolyte status. Which of the following findings should the nurse report to the provider? BUN 15 mg/dL Creatinine 0.8 mg/dL Sodium 143 mEq/L Potassium 5.4 mEq/L - Potassium 5.4 mEq/L nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. the nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min & to report back in 1 hr. Which of the followin g actions should the nurse take next? -Document the providers statement in the medical record -Complete an incident report -Consult the facility's risk manager -Notify the nursing manager - Notify the nursing manager The client states: "I am unable to eat anything without vomiting" select 3 tasks the nurse should delegate
Reassure the client that this is an expected response to grief. A nurse is caring for a client who is postoperative following a knee arthroplasty & requires the use of thigh -length sequential compression sleeves. Which of the following actions should the nurse take? -Assist the client into a prone position -Place a sleeve over the top of each leg with the opening at the knee -Make sure two finger can fit under the sleeves -Set ankle pressure at 65 mmHg - -Make sure two finger can fit under the sleeves A nurse is preparing to apply a dressing for a client who has a stage 2 pressure injury. Which of the following types of dressings should the nurse use? Alienate Gauze Transparent Hydrocolloid - Hydrocolloid A nurse is preparing an education program for the staff about advocacy. Which of the following information should the nurse include? -Advocacy ensures clients' safety, health, & rights. -Advocacy series that nurses are able to explain their own actions. -Advocacy ensures that nurses follow through on their promises to clients. -Advocacy ensures fairness in client care delivery and use of resources. - Advocacy ensures clients' safety, health, & rights. A nurse is admitting a new client. Which of the following actions should the nurse take while performing medication reconciliation? -Verify the client's name on their identification bracelet with the medication administration record -Call the pharmacy to determine whether the client's medications are available -Compare the clients home medications with the provider's prescriptions -Place the client's home medication bottles in a secure location - Compare the clients home medications with the provider's prescriptions A nurse is assessing an older adult client's risk for falls. Which of the following assessments should the nurse use to identify the client's safety need? (Select all that apply) -Lacrimal apparatus -Pupil clarity -Appearance of bulbar conjunctivae -Visual fields -Visual acuity - Pupil clarity Visual fields Visual acuity A nurse is providing discharge instructions to a client who will be using a walker. Which of the following client statements indicates an understanding of the teaching? -"I can place an extension cord across my living room to plug in my television." -"I will hire someone to trim the tree that hangs low over the stairs of my front porch." -"I will place my alarm clock on my bedroom dresser across the room." -"I will replace the old throw rug in my kitchen with a new one." - -
"I will hire someone to trim the tree that hangs low over the stairs of my front porch." A nurse is reviewing a client's fluid & electrolyte status. Which of the following findings should the nurse report to the provider? BUN 15 mg/dL Creatinine 0.8 mg/dL Sodium 143 mEq/L Potassium 5.4 mEq/L - Potassium 5.4 mEq/L nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. the nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min & to report back in 1 hr. Which of the followin g actions should the nurse take next? -Document the providers statement in the medical record -Complete an incident report -Consult the facility's risk manager -Notify the nursing manager - Notify the nursing manager The client states: "I am unable to eat anything without vomiting" select 3 tasks the nurse should delegate
