A nurse at a long-term care facility is caring for a client who requires oral suctioning.
Which of the following supplies should the nurse plan to use
... [Show More] for this task? - ANSWER
yankeurs catheter
rationale: A Yankauer catheter is a clean suction catheter used when performing oral and
oropharyngeal suctioning to remove secretions from the client's mouth to facilitate
breathing or obtain a sample for diagnostic evaluation.
A nurse in a long-term care facility is serving on the ethics committee, which is addressing
a client care dilemma. Which of the following strategies will facilitate resolving the
dilemma? (Select all that apply.) - ANSWER [1] determine the facts related to the
dilemma.
[2] identify possible solution
[3]consider the client wishes
A nurse is talking with a client whose son died in a motor-vehicle crash 2 weeks ago. The
client states, "l really thought I'd be back to my usual routines by now, but I can't think of
anything else except that my son is gone." Which Of the following responses should the
nurse make? - ANSWER Grieving for your son is hard work. it will take as much time as
you need to come to terms with your loss.
A nurse is reinforcing teaching with a client about cancer prevention. The nurse should
include that frequent consumption of which of the following foods increases the risk for
developing cancer? - ANSWER Lamb
rationale: including tuna fish reduces risk of developing cancer.
including poultry reduces risk,
A nurse notices an assistive personnel (AP) taking a nap in the break room during meal
time. The nurse also notes that the AP is drowsy while performing routine tasks. Which of
the following actions should the nurse take? - ANSWER Report the observation about the
AP to the Unit nurse manager
A nurse on a pediatric unit is collecting data from four newly admitted clients. Which of
the following clients should the nurse identify as being at risk for urinary retention? -
ANSWER A school age child who has allergic rhinitis and is taking diphenhydramine.
A nurse is caring for a client following a bronchoscopy. Which of the following actions
should the nurse take first? - ANSWER check for gag reflex
A nurse is assisting with the admission of a client who has a latex allergy. The nurse
should identify that which of the following supplies has the potential to contain latex? -
ANSWER Indwelling urinary catheter
A nurse is performing postmortem care for a client prior to the arrival Of the client's
family for viewing Of the body. Which Of the following actions should the nurse take? -
ANSWER Gently close the client's eyelids
A nurse is reinforcing teaching with a client who has dumping syndrome about measures
to reduce manifestations. Which of the following instructions should the nurse include in
the teaching? - ANSWER avoid foods high in sugar content.
rationale: The nurse should instruct the client to avoid sweet foods, which often increase
the manifestations of dumping syndrome. These manifestations include nausea, sweating,
abdominal pain, diarrhea, and weakness.
A nurse is collecting data from a client who is experiencing a situational crisis following
the loss of a job. The client states, "l don't think I can go through this again." Which of the
following actions is the nurse's priority? - ANSWER Determine if the client is experiencing
psychotic thinking.
A nurse is contributing to the plan of care for a client following a transurethral resection
of the prostate (TURP). Which of the following interventions should the nurse include? -
ANSWER Irrigate the bladder using sterile technique
A nurse is caring for an infant who is receiving IV fluids for dehydration. Which of the
following should the nurse recognize as a positive response to the therapy? - ANSWER
Moist mucus membranes.
A nurse is assisting with the admission of a client who is experiencing alcohol withdrawal.
Which of the following medications should the nurse expect the provider to prescribe for
the client? - ANSWER Chlordiazepoxide
rationale: The nurse should expect to administer chlordiazepoxide to decrease anxiety and
the risk for seizures associated with alcohol withdrawal.
A nurse is caring for a client who is scheduled for surgery in the morning. The nurse
learns that the client has decided not to have surgery even though they have already
signed the informed consent form. Which of the following actions should the nurse take?
- ANSWER report the situation to the provider who obtained informed consent.
A nurse is collecting data from a client who is in severe pain. Which of the following
questions should the nurse ask first? - ANSWER where is your pain located [Show Less]