What does client and family communication and education concerning restraints do?
- A. confuses both groups more
- B. helps with coping and stress levels
- C. encourages cooperation with the client and family
- D. puts the responsibility on the client and family, not the nurse
Correct Answer: C
Rationale: Cooperation is more likely if the client and family understand the purpose of and expected gains from restraints. Well-meaning family members might release restraints if their purpose is not clear.
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The charge nurse is observing nursing staff. In which activity illustrated should the charge nurse intervene because it places the nurse most at risk for back injury?
- A. intervene_1.PNG
- B. intervene_2.PNG
- C. intervene_3.PNG
- D. intervene_4.PNG
Correct Answer: D
Rationale: Bending and twisting the torso, as described in option D, poses the highest risk for back injury due to improper body mechanics, even with a transfer belt. The client's potential to grab the nurse's shoulder or arm increases the risk by destabilizing the nurse's stance.
The nurse is planning an educational session for a group of parents with toddlers. Based on the two leading causes of death in toddlers, the nurse should make which topics priority? Select all that apply.
- A. Water safety and methods to prevent drowning.
- B. Use of age- and weight-appropriate car seats.
- C. Nutrition guidelines and age-appropriate foods.
- D. Use of labels to identify poisonous substances.
- E. Safety when outdoors and crossing the street.
Correct Answer: A,B
Rationale: Drowning and motor vehicle accidents are the top two causes of death in toddlers, making water safety and car seat use priority topics.
A nurse taking a patient's history realizes the patient is complaining of SOB and weakness in the lower extremities. The patient has a history of hyperlipidemia, and hypertension. Which of the following may be occurring?
- A. The patient is developing CHF
- B. The patient may be having a MI
- C. The patient may be developing COPD
- D. The patient may be having an onset of PVD
Correct Answer: B
Rationale: Myocardial infarction may be associated with SOB and muscle weakness.
Serum Vancomycin levels are taken to measure which of the following?
- A. renal function
- B. therapeutic range
- C. trough levels
- D. antibiotic resistance
Correct Answer: B
Rationale: Vancomycin levels are monitored to ensure therapeutic effects by peak level.
The nurse is teaching the parents of a 3 month-old infant about nutrition. What is the main source of fluids for an infant until about 12 months of age?
- A. Formula or breast milk
- B. Dilute nonfat dry milk
- C. Warmed fruit juice
- D. Fluoridated tap water
Correct Answer: A
Rationale: Formula or breast milk. Formula or breast milk are the perfect food and source of nutrients and liquids up to 1 year of age.