4. Post-surgical pain is expected and without further parameters, no determination can be made regarding this client. e. Time, c. The nurse may serve as a witness to informed consent for organ donation (nurses may witness the consent for organ donation after a specially trained professional requests consent), 23. a. c. They tend to use more verbal communication Correct: Hot water may damage dentures so intervention is needed. A nurse is caring for a client in the orientation phase of the nurse-client relationship. Making patient assignments is an important charge nurse role that lacks theoretical support and practical guidelines. Incorrect: The charge nurse should first obtained the needed information and then decide whether to notify the nursing supervisor. a. The charge nurse on the postpartum unit is making assignments. a. Which of the following tasks should the charge nurse reassign to a licensed nurse? Select all that apply The nurse voices his concern to the charge nurse. The client asks the nurse, "Why do I need that? Remind the client to tell the nurse when he has to urinate This may result in several health problems including arrhythmias, an enlarged heart, heart failure, infections and bleeding. The client's self-report of pain severity, 88. The other options may be correct but are not the best first action. The nurse asks why the client needs to know this. b. Restock pediatric patient care rooms with oral rehydration fluids using a standardized check list., The charge nurse is preparing the patient care assignments for the day shift, assigning clients to a LPN/LVN and a certified nursing assistant (CNA). A client receives a wrong medication. Use the tablet's packaging to pick it up from the counter 3. butter, which contain 16 g of protein, 7 g of carbohydrates, 1. When asking the client about his receptiveness to the transfer A nurse is caring for a client within the intimate zone of the client's personal space. Headache following this procedure is a potential side effect and would not be the priority concern for the nurse. 3. a. c. Decreased sodium excretion Correct: The nurse's level of fatigue must be considered especially under conditions of mandatory overtime. Which of the following actions is the nurse's priority? This center functions as 'information central', where all plans or activities are coordinated and determined by those personnel. What is the most appropriate action by the charge nurse? b. a. Triage and assign color-coded tags to each client. A nurse is preparing to move a client who is only partially able to assist up in a bed. Demonstrate the use of clinical reasoning in prioritizing and evaluating the delivery of client care. INCORRECT 3) Review a low-sodium diet for a client who has hypertension. Which task would be appropriate for the nurse to assign to an LPN/VN? It is the primary healthcare provider's role to receive acceptance for transferring a client to another facility. c. Industry vs inferiority The spouse can rescind the Advance Directive if the client becomes unresponsive. Incorrect: This will take some time and would be best accomplished by sitting with the family to discuss options. a. PURPOSE AND SCOPE: Supports FMCNA's mission,vision, core values and customer service philosophy. a. a. Ask the primary healthcare provider to suggest the best oral care procedure. Incorrect: Most adults have already been exposed to the virus and are not at risk for adverse effects of the infection. d. principal. Could you try contacting a support group Although this will require assessment, this client is not the priority at this time. The nurse should identify that this client is demonstrating which of the following kulber-ross stages of grieving? A charge nurse is observing a group of newly licensed nurses. The nurse does not know the skills of the new UAP. 4. The nurse is using which of the following therapeutic communication techniques? 4. Something new could have occurred with the clients, making the assignments too heavy. Suggest splitting the shift with another nurse. Correct: If suspicious behavior occurs, it is important to keep careful, objective records. Airborne 1. Vital sign measurement Which nursing intervention should the charge nurse implement? The nurse considers various ideas submitted by team members. 4. Find a mentor Most nurses learn to make nurse-patient assign-ments from a colleague. The charge nurse knows what client would be most appropriate for this LPN? c. Make sure the client has an intake of 2,000-3,000 mL of fluid/day 4. Because positioning on a bedpan requires rolling of the client, an RN should be assigned to assess the insertion site and monitor for the presence of bleeding. The cleint's family asks the nurse for info about this type of care. Which of the following actions should the nurse take when obtaining a wound-drainage specimen for culture? Incorrect: It is out of the UAP's scope of practice to administer medication. C. Review a low-sodium diet for a client who has hypertension. b. A nurse is caring for a client who is immobile. d. Places clean linen that touched the floor in the soiled linen bag, d. Decreased calcium excretion (prolonged immobility leads to the breakdown of bone tissue; result is decreased calcium excretion), 26. The charge nurse must triage and assign clients to appropriate staff. A nurse asks a client to share personal stories. c. Notifying the provider of physical exam findings What action should the nurse implement first to ensure client safety? Incorrect: The scope of practice for the UAP encompasses basic personal care needs, ambulating, and taking vitals; however, the nurse must still verify that all tasks are accomplished in a safe manner. Feedback d. Let's wait until tonight to see if he continues his behavior, 63. Discuss the issue with the leader of the "best practices" committee. Incorrect: What seems to be going on with this client? (Select all that apply) A nurse is caring for a client who is postoperative following an appendectomy. Risperidone .5 mg PO daily 3. Which of the following is the priority action by the nurse? What information should the nurse include? e. Assessing a mole on the client's shoulder, Latin GCSE Vocab - 1st and 2nd Declension Adj, NUR 204 ATI Psychosocial Integrity Ch. 4. A nurse is working with an LPN to care for a client who is receiving a continuous IV infusion. Correct: The unlicensed nursing assistant should not turn tube feedings off or on. The nurse could definitely be part of the committee. Which of the following actions should the nurse take? b. A nurse accidentally sticks her hand with a syringe needle after administering an IM injection to a client. Focus on the client's present circumstances instead of his personal stories Collecting I & O totals for unit clients at the end of shift. b. Twist at the waist when she moves an object to one side A medical-surgical LPN has been sent to a short-staffed pediatric unit. Electric comes from the Latin word for amber, a substance which readily takes a static electric charge. The nurse assists the patient to the bedside commode and the client sustains an injury to the operative area. Encourage the client to use self-exploration Everyone knows there are others who can chair this committee better than me 5. 1. This service focuses on teaching the primary caregiver to meet the client's needs _________________ (magnanimous), a. generous Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. TRAINED TO BE RELIEF CHARGE NURSE FOR THE UNIT, COMPLETE PATIENT ASSIGNMENTS, CUSTOMER SERVICE AND PROBLEM-SOLVING PROFICIENCY JUNE 2021 - JUNE 2022 STAFF RN - 3C GI MED SURG PROFICIENT IN . a. 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. Which of the following actions should the nurse take? 3. Most likely, the clients will be aware of the disaster already, and further information could be confusing or frightening. c. Face shield A charge nurse is making client care assignments. There are a total of 10 adult clients. A charge nurse role includes front line nurse supervisor, resource nurse, bed manager, peer reviewer, patient advocate, other charge nurse duties, and staff scheduler. What is the appropriate assignment? M2.4: Making Client Care Assignments-GECC As the RN charge nurse, you are preparing to make assignments for the oncoming shift on the medical- surgical unit. Based on this information,what should the nurse do? 1. Which of the following statements should the nurse make? a. The RN requests reassigning at least one of the clients to another nurse. d. Test the pH of gastric aspirate, d. Determine if the client uses hearing aids, 86. A client diagnosed with terminal cancer wants information about an Advanced Directive for end-of-life care. Everything will be okay d. Lean back in the chair, b. b. 1. d. Go to employee health services, b. This is an elderly client who is a new admit. Personal liability coverage is not mandatory, but you should consider purchasing your own coverage 2. What should the nurse do first? Ask the client to perform a return demonstration of insulin injection The client should be assessed first to rule out respiratory difficulty and hemorrhage. A newly hired unlicensed assistive personnel (UAP) has consistently completed all assignments in a safe and timely manner. 2. a. I will be able to tell how much oxygen I'm getting by looking at the flowmeter Which of the following findings should the nurse expect? 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. 2. Tenderness over the symphysis pubis a. A client diagnosed with rheumatoid arthritis needing discharge teaching. c. Providing anticipatory guidance to a client in crisis A new UAP is efficiently completing all daily assignments accurately and in a timely manner. A nurse is filling out an incident report after finding a client lying on the floor. A nurse is developing a plan of care for a client who does not speak the same language as the nurse. Client prescribed antibiotics for cystitis. Even though the client is a child, superficial burns require only dry sterile dressings and possibly oral pain medication, both tasks which are within the scope of practice for an LPN. The women's health charge nurse is making assignments for the next shift. c. There is fluid leaking around the insertion site Which pediatric client care assignment is most appropriate for the charge nurse to delegate to the LPN/LVN? Report the incident to the charge nurse Which of the following statements should the nurse identify as an indication that the client understands the instructions? 3. . In which harmonic number n is the string vibrating? They are more direct when discussing issues (men focus on issues and discuss them more directly and readily than women do), 20. Ask for any staff objections to rearranging work hours. 4. 3. 4. b. Select all that apply. d. Talk with the client's partner, b. d. Explain the procedure to the client if they do not understand, c. Lock the medication in a room and finish preparing it after returning from the emergency (securing them and returning later to finishing preparing and administering them decreases the risk of medication errors), 72. d. Custard A nurse is orienting a newly licensed nurse about documentation of a client's information in the electronic health record. Which of the following statements should the nurse identify as an indication that the client needs further teaching? Which nurse should be assigned to care for this client? The infusion rate has stopped but the tubing is not kinked Which of the following responses should the nurse make? A newborn is admitted to the nursery with a diagnosis of rule out cytomegalovirus (CMV). Select all that apply. The reason for the UAP not feeding the client needs to be determined. Symbolic communication The charge nurse should be informed that the delegated intervention is not appropriate according to the state's Nurse Practice Act. It is quicker to administer medications intravenously in the hospital Cardiac catheterization with a decreased pedal pulse below insertion site. A nurse is caring for a client who receives intermittent enteral feedings through an NG tube. Diltiazem is a calcium channel blocker that has been ordered as a titrated drip to slow heart rate and restore a regular rhythm. 1. 1. The nurse should call for immediate help so that a safe care environment is maintained for all clients. A nurse is admitting a client who has a partial hearing loss. This client is likely in metabolic acidosis due to diabetic ketoacidosis (DKA). 5. A nurse just back from maternity leave. A nurse is preparing to obtain a blood specimen from a client by venipuncture. d. Have the client practice blood-glucose monitoring using a glucometer, d. When asking if the client took his medications this morning, 81. Furosemide 40 mg PO q.d. The partner relates her concerns about her spouse abusing alcohol and having difficulty maintaining employment. 1., 4., & 5. 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 of the following clients should the charge nurse assign to a licensed practical nurse (LPN)? 5. Select all that apply Which tasks should the charge nurse complete at the end of the shift before leaving for the day? The nurse is caring for four clients. Incorrect: If a report is made to the BON, it should be a factual documentation of specific events and actions, not a statement of impairment. A. Transporting a client who experienced a stroke 72 hr ago to the radiology department A nurse is caring for an older client who is at risk for skin breakdown. 1. Asking for an explanation 2. 1. 1., 2., & 5. Aplastic Anemia Support Group. 1. 2. The nurse should not lecture, scold or argue with the float nurse. e. Lemon gelatin, d. Use soap and water to wash the catheter after each use, 33. Which of the following instructions should the nurse include? Client diagnosed with a hemorrhagic stroke 1 week ago, who currently has a blood pressure of 170/96. e. Throw rugs, 40. A client with a fractured right humerus who reports the cast is too tight. An Advance Directive includes a Living Will and a Medical Power of Attorney. Incorrect: This is not completely practical for everyone. Provide positive feedback to the UAP. A nurse observes an adolescent client who has paraplegia sitting in a wheelchair crying. 1., 4., & 5. d. Social conversation, a. Feedback The surgeon initially prescribes a clear liquid diet. d. Voided 30 mL frequently, 48. is a new graduate in orientation. 3. This protein is released by cells in the stomach. Although this is a correct thing to inform the client, this teaching should be done by the RN and not delegated to the UAP. Turn on local news for up-to-date information on the train derailment. Pointing to the two glasses partially filled with water, the magician asked, "Which glass contains the least water?". b. b. Client admitted 48 hours ago with an ischemic stroke and a history of seizures, who has been prescribed clonazepam. Allowing staff to vent is acceptable but the nurse manager should focus on constructive methods of adjustment to the impending mandated changes.