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Anurseatalong-termcarefacilityiscaringforaclient
whorequiresoralsuctioning.Whichofthefollowing
suppliesshouldthenurseplantouseforthistask?
Yankauercatheter
Anurseinalong-termcarefacilityisservingonthe
ethicscommittee,whichisaddressingaclientcare
dilemma.Whichofthefollowingstrategieswillfacilitate
resolvingthedilemma?(Selectallthatapply)
Determinethefactsrelatedtothedilemma
Identifypossiblesolutions
Considertheclient'swishes
Anurseistalkingwithaclientwhosesondiedinamotor-
vehiclecrash2weeksago.Theclientstates,"Ireally
thoughtI'dbebacktomyusualroutinesbynow,butI
can'tthinkofanythingelseexceptthatmysonisgone."
Whichofthefollowingresponsesshouldthenursemake?
"Grievingforyoursonishardwork.Itwilltakeasmuch
timeasyouneedtocometotermswithyourloss."
Anurseisreinforcingteachingwithaclientaboutcancer
prevention.Thenurseshouldincludethatfrequent
consumptionofwhichofthefollowingfoodsincreasesthe
riskfordevelopingcancer? Lamb
Anursenoticesanassistivepersonnel(AP)takinganap
inthebreakroomduringmealtime.Thenursealsonotes
thattheAPisdrowsywhileperformingroutinetasks.
Whichofthefollowingactionsshouldthenursetake?
ReporttheobservationsabouttheAPtotheunit'snurse
manager
Anurseonapediatricunitiscollectingdatafromfour
newlyadmittedclients.Whichofthefollowingclients
shouldthenurseidentifyasbeingatriskforurinary
retention?
Aschool-agechildwhohasallergicrhinitisandistaking
diphenhydramine
Anurseiscaringforaclientfollowingabronchoscopy.
Whichofthefollowingactionsshouldthenursetakefirst?
Checkforagagreflex
Anurseisassistingwiththeadmissionofaclientwhohas
alatexallergy.Thenurseshouldidentifythatwhichofthe
followingsupplieshasthepotentialtocontainlatex?
Indwellingurinarycatheter
Anurseisperformingpostmortemcareforaclientprior
tothearrivaloftheclient'sfamilyforviewingofthebody.
Whichofthefollowingactionsshouldthenursetake?
Gentlyclosetheclient'seyelids Anurseisreinforcingteachingwithaclientwhohas
dumpingsyndromeaboutmeasurestoreduce
manifestations.Whichofthefollowinginstructionsshould
thenurseincludeintheteaching?
Avoidfoodswithahighsugarcontent
Anurseiscollectingdatafromaclientwhois
experiencingasituationalcrisisfollowingthelossofajob.
Theclientstates,"Idon'tthinkIcangothroughthis
again."Whichofthefollowingactionsisthenurse's
priority?
Determineiftheclientisexperiencingpsychoticthinking
Anurseiscontributingtotheplanofcareforaclient
followingatransurethralresectionoftheprostate(TURP).
Whichofthefollowinginterventionsshouldthenurse
include?
Irrigatethebladderusingsteriletechnique
AnurseiscaringforaninfantwhoisreceivingIVfluids
fordehydration.Whichofthefollowingshouldthenurse
recognizeasapositiveresponsetotherapy?
Moistmucousmembranes
Anurseisassistingwiththeadmissionofaclientwhois
experiencingalcoholwithdrawal.Whichofthefollowing
medicationsshouldthenurseexpecttheproviderto
prescribefortheclient?
Chlordiazepoxide Anurseiscaringforaclientwhoisscheduledforsurgery
inthemorning.Thenurselearnsthattheclienthas
decidednottohavesurgeryeventhoughtheyhave
alreadysignedtheinformedconsentform.Whichofthe
followingactionsshouldthenursetake?
Reportthesituationtotheproviderwhoobtainedthe
informedconsent
Anurseiscollectingdatafromaclientwhoisinsevere
pain.Whichofthefollowingquestionsshouldthenurse
askfirst?
"Whereisyourpainlocated?"
Anurseinaprovider'sofficeisreinforcingteachingwitha
clientwhohasanewprescriptionforferroussulfateelixir.
Whichofthefollowingstatementsbytheclientshould
indicatetothenurseanunderstandingoftheteaching?
"Iwillrinsemymouthaftertakingthismedication"
Anurseiscontributingtotheplanofcareforaclientwho
ispostoperativefollowingarhinoplasty.Whichofthe
followinginterventionsshouldthenurserecommend?
InstructtheclienttoavoidtheValsalvamaneuver
Anurseiscollectingdatafromapostpartumclientwho
hadavaginalbirth2daysago.Whichofthefollowing
findingsisthenurse'sprioritytoreporttotheprovider?
Clientreportsburningwithurination