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1. 9. A client who has a diagnosis of complete placenta previa is admitted to
the labor and delivery suite at 36
... [Show More] weeks gestation with contractions 5 min in
frequency and 1 min in duration. Which of the following actions should the
nurse take?
A. Rupture the amniotic sac
B. Medicate the client for pain
C. Prepare the client for a cesarean section
D. Perform a vaginal exam: Prepare the client for a cesarean section
2. 177. A nurse enters a client's room and finds the client lying on the floor
in a puddle of water. Which of the following statements should the nurse
document in an incident report?
A. Client fell out of bed because an assistive personnel left the rails of the
bed down
B. Client's roommate thinks the client is confused and fell when getting out
of bed
C. Client appears to have slipped in water but reports no injuries
D. Client found lying on the floor near the bedside table: Client found lying on
the floor near the bedside table
3. 178. A charge nurse on a pediatric unit is making assignments for a float
nurse from the medical unit. Which of the following clients is appropriate to
assign to the float nurse?
A. A 10-year-old client who has pneumonia and is receiving respiratory
treatments
B. A 4-year-old client who has aWilms tumor and is receiving chemotherapy
C. An 8-month-old client who is scheduled for a surgical repair of a ventricular septal defect tomorrow
D. A 14-year-old client who is scheduled for discharge today following
placement of a Herrington rod: A 10-year-old client who has pneumonia and is
receiving respiratory treatments
4. 179. A nurse is preparing to administer vancomycin to a client who has an
infected wound.The nurse should plan to monitor for which of the following
adverse reactions?
A. Hepatotoxicity
B. Ototoxicity
C. Hypercalcemia
D. Hypertension: Ototoxicity
5. 180. A nurse is assessing an infant who has water intoxication. Which of
the following findings should the nurse expect?
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A. Generalized edema
B. Elevated urine specific gravity
C.Thready pulse
D. Increased hematocrit: Thready pulse
6. 1. A home health nurse is conducting an initial home visit for a client who
has terminal breast cancer. The client has two school-age children and a
limited support system.Which of the following is the priority nursing action?
A. Inform the client of available community resources
B. Assist the client in finding child care options
C. Agree upon short-term goals for the client
D. Ask the client about their understanding of the diagnosis: Inform the client
of available community resources
7. 2. A nurse in an emerg [Show Less]