Which action demonstrates that the nurse understands the purpose of
the Rapid Response Team?
a. Monitoring the client for changes in postoperative status
... [Show More] such as
wound infection
b. Documenting all changes observed in the client and maintaining a
postoperative flow sheet
c. Notifying the physician of the client’s change in blood pressure from
140 to 88 mm Hg systolic
d. Notifying the physician of the client’s increase in restlessness after
medication change
The Joint Commission focuses on safety in health care. Which action by
the nurse reflects The Joint Commission’s main objective?
a. Performing range-of-motion exercises on the client three times each
day
b. Ensuring that the client is eating 100% of the meals served to him or
her
c. Assessing the client’s respirations when administering opioids
d. Delegating to the nursing assistant to give the client a complete bath
daily
Which action by the nurse shows an understanding of the principle of
self-determination?
a. Allowing a postoperative client to decide to take medication with
fruit juice rather than water
b. Allowing a teenager to decide not to go to a clinic when there is
evidence that she is having profuse vaginal bleeding
c. Allowing a parent to decide not to proceed with a lifesaving
operation for a 12-year-old client
d. Allowing an older client with dementia to decide not to take cardiac
medication throughout the shift
The nurse is initiating a series of teaching sessions with an older client.
What is the nurse’s highest-priority, client-centered action before
beginning the session?
a. Ensure that the client’s family is present and will participate.
b. Make certain that the client is wearing his glasses.
c. Have printed handouts ready to use during the session.
d. Schedule the session for early evening after the client’s meal.
Which action best demonstrates the nurse using client-centered care
when planning a menu for a Vietnamese client who is newly diagnosed
with diabetes?
a. Asking the client what food he or she would eat on a standard
diabetic menu
b. Asking family members to make selections for the client from a
diabetic menu
c. Ordering a typical diabetic meal for the client and planning diet
teaching
d. Researching the Vietnamese culture before discussing diabetic meal
planning
The Institute for Healthcare Improvement (IHI) identified interventions
to save client lives. Which actions are within the scope of nursing
practice to improve quality of care?
a. Insert a central line to give intravenous fluid to a dehydrated client.
b. Use sterile technique when changing dressings on a new surgical
site.
c. Intubate a client whose oxygen saturation is 92%.
d. Prescribe aspirin for a client who presents with an acute myocardial
infarction
Which action by the nurse demonstrates the best practice for nursing [Show Less]