1. a nurse is planning care for a client who is receiving heparin to treat a deep vein thrombosis of the left lower leg. which of the following
... [Show More] interventions should the nurse include in the plan of care? - elevate the affected leg
ambulation should be encouraged
2. a nurse is teaching a group of guardians about child safety measures. which of the following statements by a guardian indicates an understanding of the teaching? - I should have my child avoid sun exposure between 10 am and 2 pm
3. a home health nurse is providing teaching about infection prevention to a client who has cancer and is receiving chemotherapy. Which of the following statements by the client indicates an understanding of the teaching? - I will walk for short distances throughout the day
4. a nurse is providing dietary teaching to the parents of a 6-month-old infant. which of the following instructions should the nurse include? - Introduce new foods one at a time over 5 to 7 days
5. a charge nurse is planning care for a client who has mechanical restraints in place. which of the following interventions should the nurse include in the plan? - Provide a staff member to stay with the client continuously
can be physically or using an audiovisual device
6. need to document every 15-30 minutes, a new prescription should be in every 4 hrs for adults, every 3 hrs for 9-17 years and every hour for those younger
7. a community health nurse is assisting with the development of a disaster management plan. the nurse should include which of the following nursing responsibilities in the disaster response stage of the plan? - performing a rapid needs assessment
8. a nurse manager is assisting with the orientation of a newly licensed nurse. which of the following actions by the nurse requires the nurse manager to intervene? - tells the hospital chaplain a clients diagnosis
9. a nurse is caring for a client who is in labor at 39 weeks of gestation. during the second stage of labor, the nurse observes early deceleration on the monitor tracing. which of the following actions should the nurse take? - continue observing the fetal heart rate
these are an expected finding
10. a nurse manager is planning to make changes to the current scheduling system on the unit. to facilitate the staff's acceptance of this change, which of the following actions should the nurse manager take first? - provide information about scheduling issues to the staff
unfreezing stage - increase understanding of why change is needed
11. a nurse is planning teaching about allowable foods for a client who has a history of uric acid based urinary calculi formation. which of the following foods should the nurse include in the teaching? - oranges
can eat citrus fruits
no chicken, no organ meats like liver, no red wine (avoiding purine)
12. a charge nurse is teaching a newly licensed nurse how to identify true labor. which of the following should the nurse include in the teaching? - the cervix transitions to an anterior position
contractions will be felt in the lower abdomen and back, intensity increases with ambulation, cervix shortens and thins
13. a nurse on a medical surgical unit is caring for a client prior to a surgical procedure. which of the following findings should indicate to the nurse that the client has the ability to sign the informed consent? - the client is able to accurately describe the upcoming procedure
14. a charge nurse assigns a newly licensed nurse to care for a client who has a chest tube. The nurse expresses concern about having limited experience with monitoring chest tube drainage. which of the following actions should the charge nurse take first to provide teaching about chest tubes? - ask the nurse about their knowledge of the procedure
15. a nurse is teaching a client who has a new prescription for estradiol. for which of the following adverse effects of this medication should the nurse instruct the client to monitor and report to the provider? - headaches - can be indicative of a thromboembolic stroke [Show Less]