a charge nurse is making client care assignments

ESSENTIAL FUNCTIONS: Provide the best possible nursing care by planning, organizing, and directing the nursing functions of patients in the unit. A post-cardiac catheterization needing assistance with bedpan. A nurse is implementing direct nursing care for a group of clients in an acute care facility. Incorrect: There are situations in which the LPN must notify the primary healthcare provider. Something new could have occurred with the clients, making the assignments too heavy. A charge nurse is planning client activities for the day. 1. Which of the following findings reported by the LPN indicates to the nurse the client has phlebitis at the IV insertion site? Aplastic anemia is a rare but serious condition. a. Shakes the soiled linen to remove any toilet paper remnants This is an appropriate and safe action for the unlicensed nursing assistant to do. Incorrect: The RN is responsible for collecting data. c. Nonfat milk Notify the surgeon that the client wishes to withdraw informed consent for the procedure (the client has the right to withdraw consent therefore the surgeon should be the one notified of the request), 14. a. 1. d. I'll put a heating pad on my ankle at bedtime tonight, d. I have a set of my brothers' crutches in the basement I can also use (the client should not use crutches that belong to someone else; the crutches must fit body dimensions), 17. 1. Which of the following instructions should the nurse include? Incorrect: This client is post cardiac catheterization and remains on bedrest; therefore, the affected leg must be kept straight to prevent femoral hemorrhaging. Correct: The clue that should be picked up on here is that the client is now reporting that the cast has become too tight. There are a total of 10 adult clients. The client is reporting anxiety, discomfort, and a feeling of bloating. The nurse who made the medication error should take which of the following actions first? 3. Which of the following responses should the nurse make? A nurse is caring for a client in the orientation phase of the nurse-client relationship. Covering open wounds will help to decrease bacterial exposure until the registered nurse or primary healthcare provider can assess and treat each wound. Alcoholic Anonymous Changing a colostomy bag. The fourth client the nurse should assess is the client diagnosed with Crohn's disease who had three semi-formed stools over the past shift. c. Discard the tablet and obtain another dose of medication Which of the following infection-control precautions should the nurse use caring for this client? Select all that apply e. Feed a client who had a stroke 3 months ago, 31. Client with chronic emphysema experiencing mild shortness of breath. 4. Incorrect: Discussing the assignment with another LPN is delaying the client's needed intervention. Alcohol consumption increases the use of folates, and the alcoholic diet is usually deficient in folic acid. The partner relates her concerns about her spouse abusing alcohol and having difficulty maintaining employment. PDF 8 steps for making effective nurse-patient assignments Assist a client to ambulate using a gait belt. A nurse is planning care for a female client who has an indwelling urinary catheter. Which clients should be assigned to the CNA? A nurse is orienting a newly licensed nurse about documentation of a client's information in the electronic health record. 2. Fruity breath. Allow families unlimited visitation around the clock to meet their schedules. It also helps the client deal with issues that are important to him), 19. 1. 3. 3. However, since the new UAP's competency level is not known, the nurse does not delegate this task for the safety of the client. A nurse is caring for a client who has a mental health disorder. Measuring vital signs c. Changing a dressing, 78. 3. c. Palpating for pedal edema The nurse should use close-ended questions when assessing which of the following factors? The nurse should perform which of the following activities in this space? (Select all that apply.) d. To identify delayed gastric emptying, a. Auscultate breath should at least ever 2 hr (priority action the nurse should contribute to the plan of care when using the ABC approach to client care in auscultating breath sounds to determine the client's need for suctioning; with inactivity, secretions can pool in the airways, diminishing breath sounds and causing crackles and dyspnea), 43. d. Ambulating the client in the hallway, c. Explore the client's feelings about dietary modifications (this teaching intervention allows the client to express his acceptance of this change and focuses on affective learning), 80. 1. Provides safe, effective delivery of patient care in . The charge nurse needs additional information to make a decision. This perceived lack of control can create distrust and frustration among personnel, ultimately impacting client care. a. I will begin 48 hr before the client's discharge a. Correct: A LPN should be able to care for a client with arthralgia who requires pain medication on a regular schedule and is receiving warm compresses. A client requesting assistance packing his belongings for discharge later today., Document what the nurse believes was the cause of the ulcer development Incorrect: What seems to be going on with this client? Stand directly in front of the client Of the following barriers to learning the nurse identifies with this client, which should the nurse interpret as a need to postpone the session? For which of the following actions should the nurse intervene? Electric comes from the Latin word for amber, a substance which readily takes a static electric charge. Which of the following communication techniques should the nurse use during this phase? 4. Which task would be appropriate for the nurse to assign to an unlicensed assistive personnel (UAP)? b. Which of the following tasks should the nurse plan to delegate to assistive personnel (AP)? Ask the RN why the assignment is too heavy. d. Go to employee health services, b. A client has been admitted with folic acid deficiency anemia. A skill for which the ap has received instruction the - Course Hero c. Use an aggressive tone of voice Based on this information,what should the nurse do? Point out inconsistences in the client's behavior (a nurse using confrontation helps the client become aware of inconsistencies in his feelings, attitudes, beliefs, and behaviors. Which task should the nurse take responsibility for completing? 1. 1. A nurse is working with an assistive personnel (AP) to 3. Select all that apply 1. Client diagnosed with gastroenteritis who reported 300 mL diarrhea stool x2 in the last hour. Correct: The best first action for the nurse is to identify a problem, and follow up with the appropriate person. c. One nurse lifting the client's legs as the client uses a trapeze bar 4. A goal for this client is to use proper body mechanics at all times. Since the enema would clean below the obstruction, the client would be able to expel the enema and any feces in this part of the colon. d. I will take my medications at the first sign of an attack, d. To identify delayed gastric emptying (the nurse should measure the amount of unabsorbed formula from the previous feeding to identify delayed gastric emptying; if it is delayed the nurse should avoid overfeeding the client and causing gastric distention), 42. Each state BON differs in that also some have treatment programs they administer themselves. Provide positive feedback to the UAP. Select all that apply a. Gloves 2. c. The chances of a malpractice suit are minimal as long as you follow our policies and procedures Anyone over age 18 can have an Advanced directive. Incorrect: The purpose of a cystogram is to examine the inside of the bladder to confirm the presence or absence of abnormalities, or even obtain a biopsy. Briefly assess every client. A nurse is providing care to a client who is on strict bed rest following surgery. Two hours after other trays were picked up from the rooms, the nurse notes that the client's untouched tray is still at the bedside. Encourage clients and families to develop mutually appropriate visitation times. Ask the float nurse, "Have you been drinking?" 6. The client is getting better. d. I'll carry heavy objects close to my body, d. Places clean linen that touched the floor in the soiled linen bag, 25. Incorrect: The RN is responsible for developing the plan of care which would include necessary referrals. b. Which of the following statements should the preceptor make? A. nurse is caring for a client who is not cooperating with his care and demonstrates defiant behavior. Correct: Talking to the nurses about client concerns and completing the client assignment sheet for oncoming staff will provide for a thorough shift change report. a. Incorrect: If alcohol or drug dependency is suspected, confrontation will result in hostility and denial. This task cannot be delegated to the LPN/LVN. 2. Incorrect: Teaching is outside the scope of practice for the LPN/LVN. a. Which of the following actions indicates that the AP understands the principles of infection control? 1. There may be a good reason that the tray was not served. The area surrounding the insertion site feels warm to the touch The UAP can provide hygiene needs to a client such as perineal care and cleaning of the nares. Which of the following findings should the nurse identify as a safety risk? e. Feed a client who had a stroke 3 months ago, 32. The surgeon initially prescribes a clear liquid diet. Incorrect: While it is true that the nurse manager is ultimately responsible for implementing and announcing new schedule changes, doing so without any staff input can create discontent in the work environment. (Select all that apply.). a. Symbolic communication Client diagnosed with a hemorrhagic stroke 1 week ago, who currently has a blood pressure of 170/96. If the client is unstable, the nurse would retain the role of measuring the vital signs. A nurse is preparing medication for a client when another client has an emergency. 4. c. Inflate the balloon when the urine flow stops 2. Could you try contacting a support group This is an appropriate prescription. 1. _____The house that we lived in for nine years has been sold. 5. Narrative interaction The nurse is caring for four clients. 4. b. e. Throw rugs, 40. In planning care for the post-operative client, the nurse has decided to retain the task of vital sign assessment. A new UAP is efficiently completing all daily assignments accurately and in a timely manner. Correct: All facilities are required to develop a disaster plan, per JCAHO (Joint Commission on Accreditation of Healthcare Organizations) regulations, though the plans vary. Select all that apply 2. Incorrect: A slightly decreased pedal pulse to the affected extremity is not unusual following cardiac catheterization. c. Check to see if the suction equipment is working Client with an oral temperature of 103.2 F (39.5 C) 36 hours post intracranial surgery. a. This assumption is not appropriate, and the feelings and concerns of the client should be addressed. This documentation should go to your manager. 3. A distance of 5.00 cm is measured between two adjacent nodes of a standing wave on a 20.0-cm-long string. December 5, 2020. A nurse is attending a social event when another guest coughs weakly once, grasps his throat with his hands, and cannot talk.

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