b. 2. e. an open perineal wound, 92. Incorrect: The RN is responsible for assessment and evaluation. 1 e. Lemon gelatin, d. Use soap and water to wash the catheter after each use, 33. 2. 1. A nurse is caring for an older adult client who has a fractured hip and will require rehab care. 1. 4. This template is beneficial for nursing students and veteran nurses alike, and can be used in any unit. It's unfortunate that I have to be in the hospital for this treatment (TENS units are portable; they can be used at home), 45. This service began with the client's admission to the hospital A nurse is teaching a client about carbon monoxide poisoning. Have another nurse guard the medication preparations until the nurse returns c. The chances of a malpractice suit are minimal as long as you follow our policies and procedures Confrontation should occur in the presence of a charge nurse or supervisor. 2. b. Personal liability coverage is not mandatory, but you should consider purchasing your own coverage, 87. C. Review a low-sodium diet for a client who has hypertension. It is the primary healthcare provider's role to receive acceptance for transferring a client to another facility. Which of the following actions should the nurse take? This could be devastating to the client if the decimal point is missed and the client receives 200 mg instead of the intended 20 mg of lisinopril. Something new could have occurred with the clients, making the assignments too heavy. The charge nurse on the postpartum unit is making assignments. A nurse is having difficulty caring for a client due to variables affecting the communication process. c. I should purchase a carbon monoxide detector for my home 1. The nurse voices his concern to the charge nurse. a. The nurse prefers to check all vital signs on all clients. 2. Document current functional status assessment Correct: A thoracentesis is performed to remove fluid from the pleural cavity and improve the client's respiratory status. Which client would be appropriate for the RN to assign to the LPN? Which of the following types of torts has the nurse committed? 3. A post-cardiac catheterization needing assistance with bedpan. d. Custard b. Review a low-sodium diet for a client with hypertension. 3. Incorrect: What seems to be going on with this client? 2. 2. However, each unit must have one designated representative to send to the command center, when requested, to receive and then relay, pertinent information back to the unit. 3. Therefore, the nurse with Labor and Delivery experience would be the most appropriate one to assign to care for this client who has postpartum preeclampsia. Nurse-patient assignments help coordinate daily unit activities, matching nurses with patients to meet unit and patient needs for a specific length of time. c. I'll wear low heeled shoes from now on d. I will place a bath seat in my shower to use when I bathe, b. A nurse is teaching a client who has strained her back muscles while preparing to move to a new apartment. Nothing life threatening. Nurses dependent on drugs or alcohol can harm clients. 3. Which referral would most likely be appropriate for the nurse to make? e. Dysuria, 49. d. I have a set of my brothers' crutches in the basement I can also use, a. Which of the following actions should the nurse take? 1. Respite care allows the primary caregiver time away from day-to-day care responsibilities 4. c. Check to see if the suction equipment is working Making client care assignments As the RN charge | Chegg.com Science Nursing Nursing questions and answers Making client care assignments As the RN charge nurse, you are preparing to make assignments for the oncoming shift in the medical-surgical unit. d. The presence of a bed alarm could have prevented the client from falling, b. Assess the client (to check if there is any harm to the client), 69. b. Talk to each nurse about concerns related to assigned clients. Elderly client who fell and fractured the left femoral neck. 2. 2. The client can indicate desire for Do Not Resuscitate (DNR). A nurse is providing discharge teaching about clean intermittent self-catheterization for a client who has a benign prostatic hyperplasia. Only the state Board of Nursing can legally determine the LPN's scope of practice. "Please explain what you mean by the word 'nervous'.". An experienced neurological nurse should be assigned to this client to assess and manage for signs and symptoms of increasing intracranial pressure. INCORRECT: Although the vascular status of the foot will need to be assessed, there is no indication if the debridement has been completed yet. c. Make sure the client has an intake of 2,000-3,000 mL of fluid/day Yes! Limit the client's fluid intake in the evening The client was lying on the floor next to his bed 3. b. Everything will be okay c. To determine the client's electrolyte balance b. 208 (a client who has TB requires airborne precautions; that means a private room with negative air pressure flow), 21. Incorrect: Here, you have a client who needs teaching about intravenous pain management using a patient-controlled analgesia (PCA) pump. A client has been admitted with folic acid deficiency anemia. c. Inform the surgical team to cancel the client's surgery One important aspect is encouraging the flow of ideas between management and staff members. LPNs can provide the client with needed analgesics or may simply guide the client with diversional activities for managing this type pain. c. Initiate a liquid diet for the client The below statement corresponds to a numbered sentence in the passage. 3. 4. They are more direct when discussing issues (men focus on issues and discuss them more directly and readily than women do), 20. Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. Incorrect: The wash cloth is placed in the sink to prevent the dentures from breaking if they are dropped. 4. 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. b. The charge nurse should notify the nursing supervisor who will seek additional staff. 2. 1. Incorrect: Irrigating a client's ear canal is outside the UAP's scope of practice. d. Fill linen bags with as much soiled linen as possible, b. Negligence (negligence is the failure to provide the expected standard of care. a. Notify the board of nursing (BON) that the float nurse is an alcoholic. The UAP can provide hygiene needs to a client such as perineal care and cleaning of the nares. Splitting the overtime shift is an acceptable option that the nurse could suggest in order to solve the staffing problem and decrease the amount of time the nurse will be working. The first client who needs treatment is the one with multiple injuries from a motor vehicle accident. The nurse is planning care for a client admitted with Alzheimer's Disease. Correct: The clue that should be picked up on here is that the client is now reporting that the cast has become too tight. 4. a. Incorrect: Discharging a client includes teaching and a review of medications to be taken at home. A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding herself using adaptive devices. a. Transpersonal b. Intrapersonal c. Interpersonal d. Public b. 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. The RN who has worked in Labor and Delivery would have knowledge and experience caring for clients with preeclampsia. b. I will begin once the client's discharge order is written This task cannot be delegated to the LPN/LVN. 3. d. The nurse has already considered alternatives to restraints, a. Which of the following actions should the nurse take when obtaining a wound-drainage specimen for culture? A Medical Power of Attorney is a type of Advance Directive that appoints a health care agent to make decisions on the client's behalf when the client is unable to do so. b. This item: Nursing Brain Sheet Multiple Patient Notebook - Nurse and CNA Report Sheet - 3 Patients per Template $1999 BadgeGuru by Tribe RN - 52 Cheat Sheets on 26 Nurse Badge Cards - Designed by Nurses, for Nurses - Essential for Nurses and Nursing Students - Bonus Access to Our Digital Resource Library - Inverted $1997 ($0. a. c. I will place an area rug at the entry of my bathroom c. Consensus evolves in this stage This stage involves constructive efforts on the part of the group members Which of the following actions should the nurse take? d. Anger, b. Following a passenger train derailment, local hospitals are notified to activate disaster protocols on all floors. b. The last client would be the one needing dietary education. The charge nurse on each unit needs to prepare a list of possible discharges or transfers to be given to the appropriate primary healthcare providers for further action. Sudden attacks of sleep What is the best response by the charge nurse? 4. A nurse is implementing direct nursing care for a group of clients in an acute care facility. 2. c. I will begin upon the client's admission to the facility Client two days post percutaneous endoscopic gastrostomy (PEG) placement. Warm the feeding solution to the body temperature Providing a passive response Assist a client to ambulate using a gait belt. If you are new to this challenge, try these eight tips as a guide for making nurse-patient assignments. a. Diltiazem is a calcium channel blocker that has been ordered as a titrated drip to slow heart rate and restore a regular rhythm. Which of the following clients should the charge nurse assign to a licensed practical nurse (LPN)? Incorrect: The nurse is assuming that the client's quarrelsome behavior is normal for this client. Which of the following instructions should the nurse give to the client prior to the procedure? Provides day to day direction and supervision to assigned direct patient care staff. Triage and assign color-coded tags to each client. Which of the following actions should the nurse take regarding informed consent? Sit side-by-side with the client Skill level and scope of practice of each staff member, Exit HESI (Actual hesi hints), EXIT HESI 2, Julie S Snyder, Linda Lilley, Shelly Collins. ESSENTIAL FUNCTIONS: Provide the best possible nursing care by planning, organizing, and directing the nursing functions of patients in the unit. Which pediatric client care assignment is most appropriate for the charge nurse to delegate to the LPN/LVN? The client is getting better. Handoff and Nursing Report Sheet. A nurse enters an older adult client's room to insert a saline lock. Showing disapproval 2. (Select all that apply) The nurse chooses to confront the client. A special protein, called intrinsic factor (IF), binds vitamin B12 so that it can be absorbed in the intestines. 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). 3. Which of the following actions should the nurse take prior to administering the tube feeding? The RN will also need to be in communication with the assisted living facility to ensure that they have are a support system for the patient and her follow up care with her pacer. Which of the following responses should the nurse make? A nurse receives a client care assignment from the charge nurse that he believes is unfair. The third client that should be assessed by the nurse is the client diagnosed with hemorrhoids who had some spotting of bright red blood on toilet tissue with last bowel movement. b. I'll do exercises that strengthen my abdominal muscles A nurse in a dialysis center is caring for a client who has a new diagnosis of end-stage kidney disease. 4. It is not a routine task. Encourage clients and families to develop mutually appropriate visitation times. c. Paraphrasing a. It is the nurse's responsibility to communicate the client's condition and care plan to the receiving facility nurse in order to support continuity of care. Lumbar puncture reporting a headache. These irregularly shaped cells can get stuck in small blood vessels, which can slow or block blood flow and oxygen to parts of the body. A nurse is caring for a client who is immobile. Inform the client of the need to avoid irritants such as carbonated beverages. Irrigate a client's ear canal. Select all that apply. A nurse is completing discharge teaching with a client. - Assisting a client to ambulate using a gait belt. d. Use soap and water to wash the catheter after each use, c. Consensus evolves in this stage (consensus occurs and cooperation develops during the norming stage), 34. 3. An experienced nurse would be assigned to this unstable client due to the possibility of a reoccurring hemorrhagic stroke resulting from the client's hypertension. A newly hired nurse in a long term care facility has been asked to assist with revising old policies regarding family visitation schedules. b. This individual should be provided appropriate comments of appreciation for this accomplishment. c. Gender Incorrect: Dealing with a client's emotional state requires a formative evaluation to gauge readiness and requires the knowledge of the RN. A nurse is admitting a client from a long-term care facility. Client diagnosed with inoperative brain tumor who is confused. 4. 4. 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. Assist ait to ambulate using a gait belt. 4. Soaking the dentures in hot water EXAMPLE: Of my three brothers and sisters, my sister Giselle has the better sense of humor. a. Explain administration is demanding a decreased overtime. 3. Correct: The hospital nurse to client staffing ratio should reflect the complexity of nursing care for high acuity clients. Which tasks should the charge nurse complete at the end of the shift before leaving for the day? Oral surgeon Incorrect: This client is exhibiting early signs of increased intracranial pressure. 4. Assessing this client and titrating the diltiazem requires the skills of an RN. 1. The nurse suggest that the family might need to respite care services. Correct: Traction should never be relieved without a primary healthcare provider's prescription. 4. A written report of the incident is completed by the nurse and turned into the appropriate person (generally the performance improvement department). Which task should the nurse take responsibility for completing? Which of the following manifestations should the nurse identify as an indication for discontinuing the application due to a systemic response? Review the action of insulin therapy 1. The nurse is caring for four clients. Which of the following actions should the nurse take? Assist a client to ambulate using a gait belt c. Helping the client into the shower 3. 6. b. I will try to anticipate and avoid stressful situations when possible 2. Incorrect: Emergency room nurses deal with life threatening emergencies but are not specialized in the care of clients with preeclampsia. Room 208 is a private, negative pressure airflow room; room 212 is a semi private, positive airflow pressure room; 214 is a negative pressure room, a semi private room; and room 216 is a private positive-pressure airflow room. INCORRECT: There is no information regarding how recent was the surgery or the degree of pain being experienced. A charge nurse is making assignments for an oncoming shift. Which preoperative prescription should the nurse question? The RN with 5 years' experience in the Labor and Delivery unit. a. 3. 1. Incorrect: There are situations in which the LPN must notify the primary healthcare provider. 5. Following the teaching, the nurse asks the client to describe one physical effect. This nurse does not have much experience on this unit and may not have cared for a client with postpartum preeclampsia before. b. b. A client with an above the knee amputation reporting phantom pain. 2. Even though this nurse just had a baby, there is no risk of her transmitting this virus to her child. Which of the following tasks should the nurse delegate to unlicensed assistive personnel (UAP)? 4. 5. Announce the new changes at the monthly staff meeting. c. The client's culture Incorrect: The RN is responsible for teaching. These individuals are selected by the charge nurse, and do not have to be nurses. Select all that apply Teaching about a medication d. Highly concentrated urine, 91. A nurse is caring for a client who expresses anxiety about his impending surgery. c. I'll clean the inside of the container with a wipe b. Incorrect: The client does need to have food; however, there is another action that should be performed first. 4. a charge nurse is making client care assignments for the day. 2. Which nurse should be assigned to care for this client?

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