Leadership comprehensive final

Leadership comprehensive final The nurse employed in an emergency department is assigned to triage clients coming to the emergency department for treatment on the evening shift. The nurse should assign priority to which client? - ANS a client with chest pain who states that he just ate pizza that was made with a very spicy sauce A nurse has just received the assignment for the day shift. After making initial rounds and checking all the assigned clients, which client should the nurse plan to care for first? - ANS a client with a fever who is diaphoretic and restless The nurse is giving a bed bath to an assigned client when an unlicensed assistive personnel (UAP) enters the room and tells the nurse that another assigned client is in pain and needs pain medication. Which is the most appropriate nursing action? - ANS Cover the client, raise the side rails, tell the client that you will return shortly, and administer the pain medication to the other client. The registered nurse is planning the clients assignments for the day. Which is the most appropriate assignment for an unlicensed assistive personnel (UAP)? - ANS a client who requires urine specimen collections The nurse employed in a long-term care facility is planning assignments for the clients on a nursing unit. The nurse needs to assign four clients and has a licensed practical (vocational) nurse and three unlicensed assistive personnel (UAP) on a nursing team. Which client would the nurse most appropriately assign to the licensed practical (vocational) nurse? - ANS a client requiring abdominal wound irrigations and dressing changes every 3 hours. DELEGATION QUESTION ???? (SATA) - ANS ALL OF THEM ARE CORRECT! ineffective delegation question between nurse and UAP?? - ANS Negligence The nurse hears a client calling out for help, hurries down the hallway to the client's room, and finds the client lying on the floor. The nurse performs an assessment, assists the client back to bed, notifies the health care provider of the incident, and completes an incident report. Which statement should the nurse document on the incident report? - ANS the client was found lying on the floor The nurse arrives at work and is told to report (float) to the intensive care unit (ICU) for the day because the ICU is understaffed and needs additional nurses to care for the clients. The nurse has never worked in the ICU. The nurse should take which action first? - ANS identify tasks that can performed safely in the ICU The nurse manager has implemented a change in the method of the nursing delivery system from functional to team nursing. An unlicensed assistive personnel (UAP) is resistant to the change and is not taking an active part in facilitating the process of change. Which is the best approach in dealing with the UAP? - ANS Confront the UAP to encourage verbalization of feelings regarding the change. a question about a power of attorney.. - ANS a question that has "clustering, to allow time for breaks" as an option. DONT REMEMBER THE ANSWER - ANS secondary hypertension differs from primary how - ANS secondary HTN has a cause preventing pain with prn IBU - ANS mix NSAID and an opioid, why? - ANS Lasix - ANS loop diuretic person with HTN should not use tobacco d/t ??? - ANS Demerol - ANS check BP BETA blocker and Lasix, with elderly - ANS risk for dehydration risk factors for primary hypertension - ANS obesity, diet, saturated fat common cause for Hypertension - ANS atherosclerosis difference between hypertension urgency and EMERGENT , emergent causes........ - ANS target organ damage which intervention is most likely to decrease mortality in the septic patient? - ANS antibiotics a 12 year old child Is admitted to the hospital for observation after sustaining a head injury. Twelve hours after the injury the child has non of the signs and symptoms of a head injury. What is the nurses priority intervention at this time? - ANS assessing the level of consciousness every hour a child exhibits physical symptoms in response to stress. What nursing intervention may help the client reduce the use of physical symptoms as a response to stress? - ANS assisting the client in developing new coping mechanisms what is the most appropriate nursing intervention for clients who exhibit mild cognitive impairment ? - ANS reality orientation a client with a history of severe intermittent claudication has a femoral-popliteal bypass graft. What is an appropriate postoperative nursing intervention on the day after surgery? - ANS assist the client with walking a nurse is caring for several postoperative clients who had abdominal surgery. What independent nursing intervention can help prevent the development of thrombophlebitis? - ANS helping the client perform in-bed exercises a clients respiratory status deteriorates, and endotracheal intubation and positive pressure ventilation are instituted. What is the nurses most immediate intervention at this time? - ANS assess the clients response to the interventions a nurse administers sodium polystyrene sulfonate (kayexalate) to a client with chronic renal failure. Which findings provides evidence that the intervention is effective? - ANS potassium decreases to 4.2 mEq/L which nursing intervention is most helpful in meeting the needs of an older adult with the diagnosis of dementia of the Alzheimer type? - ANS simplifying the environment as much as possible and eliminating the need for decisions and choices twelve hours after subtotal gastrectomy, a nurse identifies large amounts of bloody drainage from the clients nasogastric (NG) tube. The nurse should: - ANS assess vital signs A 5-year-old child undergoes cardiac catheterization. The child is in the post-cardiac catheterization unit for 2 hours when the incoming nurse receives the report from the outgoing nurse. Which part of the child's report should the incoming nurse question? - ANS bedrest with bathroom privileges A nurse in charge in the surgical intensive care unit notes that a number of clients do not seem to be responding to morphine that was administered for pain. Later in the evening the nurse finds a staff nurse dozing in the nurses' lounge. When awakened, the staff nurse appears uncoordinated and drugged, with slurred speech. What should the nurse in charge do? - ANS ask the nurse manager to be present before confronting the staff nurse