2. b. 2. 3. The client was lying on the floor next to his bed 1. Elderly client who fell and fractured the left femoral neck. Nursing questions and answers. Incorrect: This again is assessment which is the role of the RN only. Which region of the tRNA pairs with mRNA? The first vital sign check was performed by the nurse. Correct: It would be best to explore the reason the RN thinks the assignment is too heavy. Provide a between meal supplement to the client. Incorrect: The charge nurse cannot change the scope of practice for the LPN by evaluating the intervention. d. When asking if the client took his medications this morning, 82. Incorrect: An experienced neurological nurse should be assigned to this client due to the possibility that damage to the hypothalamus which controls body temperature has occurred. This will allow the charge nurse to analyze the situation to make a better decision as to whether the assignment should be changed. During lunch, Robin jotted a letter to Amy and signed it, "your friend, Robin.". The nurse is responsible for the assessment of all vital signs of post-op clients. ATI Leadership and Management Questions - Leadership Management of Care If a sentence is already correct, write CCC. The charge nurse is planning the staff assignments for the clients on a neurological unit. 3. Incorrect: This client does not have a predictable outcome. Assign more daily tasks to the UAP. Which of the following tasks should the charge nurse reassign to a licensed nurse? Incorrect: The RN is responsible for assessment and evaluation. Incorrect: The RN is responsible for teaching. d. Sleep apnea Client reporting a headache and has a fruity breath. Which client can be assigned to the LPN? a. Asking for an explanation Which client would be appropriate for the RN to assign to the LPN? b. Correct: A thoracentesis is performed to remove fluid from the pleural cavity and improve the client's respiratory status. This action will promote the client's self-esteem, and may reduce the quarrelsome behavior. During exacerbation, the client will have many diarrhea stools. Removing the client's dentures 4. They are able to manage tasks related to basic care. There may be a good reason that the tray was not served. Which of the following findings reported by the LPN indicates to the nurse the client has phlebitis at the IV insertion site? Serve food that have a hot/cold balance c. The client was restless and trying to get out of the bed all evening Headache following this procedure is a potential side effect and would not be the priority concern for the nurse. Report of feeling pressure Elevating the head of the bed 30- 40 for the client post thoracotomy When determining if the client is eating a well-balanced diet 1. a. 4. Before administering a feeding, the nurse should measure the gastric residual for which of the following purposes? 4. Which of the following actions by the nurse is considered an indirect nursing care activity? Triage and assign color-coded tags to each client. C-section planning discharge, postpartum infection, mastectomy. The nurse should not assume that the UAP just did not do their job, but needs to ascertain the reason for not feeding the client. Start MgSO4 at 3g/hr IV Incorrect: This would unnecessarily alarm the clients. NUR 204 ATI Management of Care Ch. 1-9 Flashcards | Quizlet Taking the report from the ED could be delayed but is a courtesy to the ED and will provide information about the client that will be useful in making assignments for the next shift. 3. Review the action of insulin therapy a. Client with chronic emphysema experiencing mild shortness of breath. Based on the information provided in report, which client condition should be the nurse's priority? a. If the decimal point is missed in this situation, the client could receive 5 mg instead of the intended dose of 0.5 mg of risperidone. What actions should a nurse take to provide continuity of care when discharging a client diagnosed with hemiparesis to a long-term care facility for rehabilitation? 1. After making initial assessment rounds on assigned clients in the morning, the RN tells the charge nurse that the clients are too difficult. Problems in Delegation: A Busy Day on the Floor - Quizlet Ask the charge nurse to evaluate the intervention. Select all that apply d. I'll use each cleansing wipe twice, d. I decline this opportunity at this time (assertive because it contains an "I" statement and it is clear and firm), 52. 2. No! A nurse is teaching a client who has a history of falls about home safety. Correct: Documentation of the client's baseline functional status is important for the receiving facility to work with in further goal setting. If the LPN notes any serious bleeding situations, it would need reported immediately to the RN. Select all that apply A nurse is discussing the norming stage of the group development process with a student nurse. d. Respite care is a continuation of psychological support after a family member dies. Allowing staff to vent is acceptable but the nurse manager should focus on constructive methods of adjustment to the impending mandated changes. Correct: The client must have lost decision-making capacity because of a condition that is not reversible or must be in a condition that is specified under state law, such as a terminal, persistent vegetative state, irreversible coma, or as specified in the Advanced Directive. The nurse has another priority. Which of the following actions should the nurse take? The LPN/LVN can gather data, but the RN is responsible for validating and interpreting that data to assess and evaluate. A nurse is caring for a client whose partner asks to speak with the nurse. Incorrect: The concern here is the client being fed their meal. Personal liability coverage is not mandatory, but you should consider purchasing your own coverage, 87. The nurse has received the change-of-shift report. a. Prior to turning feeding back on, tube placement needs to be verified. 3. Point out inconsistences in the client's behavior What is the primary factor for the charge nurse to consider when delegating care? Underline the adjective clause in each sentence. (Select all that apply.). Which of the following statements should the nurse identify as an indication that the client needs further instruction? 1. Incorrect: It is out of the UAP's scope of practice to administer medication. A post-cardiac catheterization needing assistance with bedpan. Restock pediatric patient care rooms with oral rehydration fluids using a standardized check list., 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). Making patient assignments is an important charge nurse role that lacks theoretical support and practical guidelines. There are potential problems in Options #1, 2, 3, and 4 and should be questioned and corrected. c. Helping the client into the shower 3. Initiative vs guilt Schedule visiting times in two-hour increments so clients are not overwhelmed. Which of the following tasks should the nurse plan to delegate to assistive personnel (AP)? a. This may result in several health problems including arrhythmias, an enlarged heart, heart failure, infections and bleeding. Witness the client's signature Correct: An LPN should be assigned clients with predictable outcomes. 5. 3. The word or phrase that you choose must express roughly the same meaning as the italicized word in the passage. On an ongoing basis, the charge nurse evaluates individual and collective outcomes of the patient care provided during their shift, compares patient care delivery to accepted standards, adjusts assignment of resources as necessary, and reports changing needs and outcomes to the health care staff. e. The urge to move the legs when trying to sleep, 66. 3. a. Which of the following clients should the charge nurse assign to a licensed practical nurse (LPN)? Thus they are kept in charge of basic patient care like administration of tests, medicines and proper provision of the required treatment. Client one day post kidney transplant. d. Determine if the client uses hearing aids, b. Incorrect: This is doing research, which requires the research process be implemented, including appropriate approval. c. The restraints should promote the client's safety and prevent injuries Accept assignment, documenting personal concerns regarding work conditions. c. Review a low-sodium diet for the client who has hypertension Monitor for GI upset 30 minutes after meals. d. Complete an incident report, 70. Gather and apply dressings to open wounds. Checking capillary refill beneath the client's fingernail Review a low-sodium diet for a client with hypertension. Documentation is a communication tool for the interprofessional health care team. d. There is no blood return when the tubing is aspirated, c. I will cover the catheter so he cannot see it (using stockinette or clothing to cover the IV insertion site is an appropriate distraction technique and might steer the client's attention away from the catheter), 62. It involves people who are constantly changing-their conditions improve and deteriorate, they're admitted and discharged, and their nursing needs can change in an instant. Changing a colostomy bag. The client can indicate desire for Do Not Resuscitate (DNR). Did you recognize ureterolithiasis as "kidney stones"? c. I will cover the catheter so he cannot see it Which of the following types of communication breakdown does this response represent? A nurse is giving a presentation about client confidentiality to a group of newly licensed nurses. Discuss the competency of the surgeon Turning off continuous tube feeding to reposition a client, then turning the feeding back on. Place the client in a lateral position 4. 1. A nurse is caring for a client who frequently attempts to remove his IV catheter. 1. The nurse prefers to check all vital signs on all clients. Receive report from the emergency department (ED) on a new client. Client #1 has COPD, and, although complaining of shortness of breath, that is not unusual for clients with this diagnosis. This would be out of the UAP's scope of practice. Incorrect: Sickle cell anemia is not caused by folic acid deficiency, so this client would not need a referral to this society. 2. 1. Explain oral hygiene to a client receiving chemotherapy 208 with this question, the nurse is using which of the following communication techniques? Gather supplies to prepare room for isolation. c. I suggest you talk with a mental health counselor about your concerns c. I'll bear weight on my ankle for 10 minutes every hour Which of the following actions should the nurse take first? In planning care for the post-operative client, the nurse has decided to retain the task of vital sign assessment. An adult (18 years or older) can create an advanced directive. a. One nurse lifting as the client pushes with his feet Reporting laboratory findings to a member of the client's family (the only people allowed to receive info are those that the client has given permission and those that are working with the client and their case), 29. a. This client would be the priority based on the need for prompt recognition and treatment of the neutropenia and signs of infection present. Protective (clients whose immune system is compromised, such as from chemo, AIDS, or after a stem-cell transplant, require a protective environment), 97. Photo comes from the Greek word for light. 3. Incorrect: There are situations in which the LPN must notify the primary healthcare provider. American Sickle Cell Anemia Association Stand directly in front of the client d. Breathing in carbon monoxide can cause headaches and nausea, c. Take the client to the bathroom every 2 hr (this establishes a regular pattern of toileting and the client learns to trust that the staff will place value on his bladder-training needs), 59. However, providing care for missing teeth would also be within the LPN scope of practice. Select all that apply. Incorrect: This option would create total chaos, interrupting sleep patterns and staffing schedules. A nurse is preparing an education presentation about organ donation for a group of newly licensed nurses. 2. A client receives a wrong medication. Incorrect: While it is true that the nurse manager is ultimately responsible for implementing and announcing new schedule changes, doing so without any staff input can create discontent in the work environment. 4. 1. Demonstrate principles of collaborative practice within the nursing and healthcare teams fostering mutual respect and shared decision-making to achieve stated outcomes of care.
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