Nokea
Mr. H. is upset regarding being in the hospital for another day because he states it costs too much. The rights he is likely to demand include all of the following except:
- A. the right to examine and question the bill
- B. the right to reasonable response to requests
- C. the right to refuse treatment
- D. the right to confidentiality
Correct Answer: D
Rationale: The client's concern about costs suggests he may demand to examine the bill, expect reasonable responses, or refuse treatment. Confidentiality, while a right, is unrelated to his stated financial concerns and is not suggested to be breached.
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Accurate documentation of assessment findings regarding pressure ulcers is very important because:
- A. The law requires the nurse to document lesions
- B. The hospital requires the nurse to document lesions
- C. The physician requires the nurse to document lesions
- D. The nursing assessment of ulcers is a standard of nursing practice
Correct Answer: D
Rationale: Documenting pressure ulcers is a nursing standard to promote continuity of care and prevent progression, not merely a legal or institutional requirement.
A nursing care plan for a client with sleep problems has been implemented. All of the following should be expected outcomes except:
- A. the client reports no episodes of awakening during the night.
- B. the client falls asleep within 1 hour of going to bed.
- C. the client reports satisfaction with his amount of sleep.
- D. the client rates sleep as an 8 or more on the visual analog scale.
Correct Answer: B
Rationale: An expected outcome is that the client falls asleep shortly after going to bed.
While repositioning the client, the LPN notices a shallow, open ulcer on the sacrum with partial-thickness skin loss. What is the classification stage of this ulcer?
- A. Stage I
- B. Stage IV
- C. Stage II
- D. Stage III
Correct Answer: C
Rationale: An ulcer is classified as stage II when the skin is not intact and there is partial-thickness skin loss. An ulcer with full-thickness skin loss would be stage III.
The client with an indwelling urinary catheter requires discharge teaching. Which interventions should the nurse include in the teaching plan? Select all that apply.
- A. Plan to change the urinary catheter once a week.
- B. Cleanse the perineal area daily with soap and water.
- C. Secure the catheter tubing to the thigh with tape.
- D. Avoid showering while the catheter is in place.
- E. Perform hand hygiene before and after catheter care.
Correct Answer: B,C,E
Rationale: B: Daily cleansing with soap and water prevents infection. C: Securing the catheter reduces trauma. E: Hand hygiene minimizes infection risk. A: Monthly changes are recommended unless blockage occurs. D: Showering is safe if the client's condition allows.
The NSAID that is comparable to morphine in efficacy is:
- A. Feldene.
- B. Stodal.
- C. Toradol.
- D. Elavil.
Correct Answer: C
Rationale: Toradol is the first injectable NSAID equal to morphine in efficacy.