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A nurse on a medical surgical unit is caring for a group of clients with the assistance of a licensed practical nurse (LPN) and assistive personnel. Which of the following tasks should the nurse assign to the LPN?
- A. Providing postmortem care for a client who has just died
- B. Reinforcing dietary teaching with a client who has heart disease
- C. Accompanying a client who just had a wound debridement to physical therapy
- D. Obtaining a urine specimen from an older adult client
Correct Answer: D
Rationale: The correct answer is D, assigning the task of obtaining a urine specimen from an older adult client to the LPN. This task falls within the scope of practice for an LPN as it involves basic nursing skills and does not require critical thinking or assessment. LPNs are trained to perform routine procedures such as specimen collection under the supervision of a registered nurse. Providing postmortem care (A) requires emotional support and specialized knowledge beyond the LPN's scope. Reinforcing dietary teaching (B) and accompanying a client to physical therapy (C) involve critical thinking and assessment skills that are typically within the RN's scope. Therefore, D is the correct choice.
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A nurse is providing an in-service about actions to take during a fire on the unit. Which of the following instructions should the nurse include?
- A. Place dry towels at the base of doors.
- B. Move client care equipment into the hallway.
- C. Close the windows in client rooms.
- D. Use the fire extinguisher by aiming at the top of the flames.
Correct Answer: C
Rationale: The correct answer is C: Close the windows in client rooms. Closing windows can help prevent the spread of fire by limiting oxygen supply. This action can help contain the fire within the unit and prevent it from escalating. Placing dry towels at door bases (choice A) can be dangerous as they can catch fire. Moving client care equipment into the hallway (choice B) can obstruct evacuation routes. Using a fire extinguisher by aiming at the top of flames (choice D) is incorrect as the base of the fire should be targeted to extinguish it effectively.
A nurse is providing teaching to a client about advance directive. Which of the following statements by the client indicates an understanding of the teaching?
- A. Once I sign my living will, a family member must co-sign it.
- B. My durable power of attorney for health care is part of my advance directives.
- C. I will wait until I have a serious health problem to sign my advance directives.
- D. My doctor will need to provide approval for the decisions outlined in my living will.
Correct Answer: B
Rationale: The correct answer is B: My durable power of attorney for health care is part of my advance directives. This statement indicates understanding because a durable power of attorney for health care is a legal document that allows an individual to appoint someone to make healthcare decisions on their behalf if they are unable to do so. Advance directives include both living wills and durable powers of attorney for health care. Therefore, acknowledging that the durable power of attorney for health care is part of advance directives demonstrates comprehension of the topic.
Incorrect Answers:
A: Once I sign my living will, a family member must co-sign it - This is incorrect as a living will does not require a family member to co-sign.
C: I will wait until I have a serious health problem to sign my advance directives - This is incorrect as advance directives should be completed before a health crisis occurs.
D: My doctor will need to provide approval for the decisions outlined in my living will - This is incorrect as the decisions in a living will are made
A nurse is serving on a committee whose task is to plan cost-effective care at the facility. Which of the following client care tasks should the nurse recommend?
- A. Change total parenteral nutrition IV tubing every 48 hr.
- B. Replace total parenteral nutrition solution bags every 48 hr.
- C. Replace peripheral IV solution bags every 96 hr.
- D. Change peripheral IV primary tubing every 96 hr.
Correct Answer: D
Rationale: The correct answer is D: Change peripheral IV primary tubing every 96 hr. This recommendation aligns with evidence-based practice guidelines for preventing infection risk associated with IV therapy. Changing the peripheral IV tubing every 96 hours helps reduce the risk of contamination and infection. Choice A is incorrect because changing total parenteral nutrition IV tubing every 48 hours is not necessary unless there is a specific indication. Choice B is incorrect as replacing total parenteral nutrition solution bags every 48 hours is not a standard practice and can lead to wastage. Choice C is incorrect because changing peripheral IV solution bags every 96 hours is less critical than changing the primary tubing.
A charge nurse is receiving change-of-shift report. Which of the following situations should the charge nurse address first?
- A. The emergency department nurse is waiting to give report on a new admission.
- B. Two staff members have called to say they will be absent.
- C. A nurse on the previous shift wrote an incident report about a medication error.
- D. Transport assistance is unavailable to take a client to occupational therapy.
Correct Answer: A
Rationale: The correct answer is A because the charge nurse should address urgent situations first. The emergency department nurse waiting to give report on a new admission indicates a critical patient needing immediate attention. Addressing this first ensures timely and appropriate care for the patient. Choices B and D, staff absences and transport assistance availability, can be managed after addressing the urgent patient situation. Choice C, the incident report about a medication error, is important but not as time-sensitive as the new admission report. Therefore, the charge nurse should prioritize addressing the emergency department nurse's report first.
A nurse is caring for a client who has a new diagnosis of Crohn's disease and is interested in learning more about their condition. Which of the following actions should the nurse take?
- A. Encourage the client to research Crohn's disease on websites that have a gov address.
- B. Ask a licensed practical nurse to explain Crohn's disease to the client.
- C. Recommend podcasts that discuss Crohn's disease to the client.
- D. Suggest that the client read articles that recommend specific treatments for Crohn's disease.
Correct Answer: A
Rationale: The correct answer is A: Encourage the client to research Crohn's disease on websites that have a gov address. This option is the most appropriate because government websites provide reliable and evidence-based information on medical conditions. The client can access accurate and up-to-date information to better understand their condition.
Choice B is incorrect because a licensed practical nurse may not have the same level of expertise and resources as a government website. Choice C is incorrect as podcasts may not always provide detailed and accurate information. Choice D is incorrect because reading articles recommending specific treatments may not provide a comprehensive understanding of the disease itself. It is important for the client to have a solid foundation of knowledge about Crohn's disease before delving into treatment options.