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The home health nurse is using the home Safety Assessment Scale to evaluate the dangers that may exist in the home of the client who is mildly cognitively impaired. Which finding on the scale should be most concerning to the nurse?
- A. Lives alone and has no spouse or living children
- B. Places cloth items on stove when burners are on
- C. Is unable to recognize when food is spoiled
- D. Has poor vision and doesn't wear glasses
Correct Answer: B
Rationale: Placing cloth items on a hot stove poses an immediate fire risk, which is the most concerning safety hazard for a cognitively impaired client.
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Which of these actions by the nurse best prevents medication errors when administering medications to a client?
- A. Checking the client's wristband before giving medications
- B. Using two forms of client identification before administering medication
- C. Administering medications at the exact time they are ordered
- D. Verifying the medication order with another nurse
Correct Answer: B
Rationale: Using two forms of client identification (e.g., name and medical record number) is the best practice to prevent medication errors by ensuring the right client receives the medication.
The nurse seeks to assess the renal function of an elderly client who is about to receive a nephrotoxic medication. Which of the following labs provides the best indicator for renal function?
- A. urinalysis
- B. creatinine and blood urea nitrogen
- C. chemistry of electrolytes
- D. creatinine clearance
Correct Answer: D
Rationale: Due to decreases in lean body mass, blood creatinine is not as good an indicator of the elderly client's renal function as creatinine clearance. Creatinine clearance is a widely used test for glomerular filtration rate.
The nurse is assessing a client who states her last menstrual period was March 16, and she has missed one period. She reports episodes of nausea and vomiting. Pregnancy is confirmed by a urine test. What will the nurse calculate as the estimated date of delivery (EDD)?
- A. 8-Apr
- B. 15-Jan
- C. 11-Feb
- D. 23-Dec
Correct Answer: D
Rationale: December 23. Naegele's rule states: Add 7 days and subtract 3 months from the first day of the last regular menstrual period to calculate the estimated date of delivery.
Prior to checking a fingerstick blood glucose level, the nurse checks the identification band of the newly admitted client transferred from another facility. The nurse notes that the name and birth date are correct but that the band has the logo from another facility. Which is the best action by the nurse?
- A. Ask the UAP to obtain a new band while the nurse performs the planned procedure.
- B. Stop and replace the band with the current facility band that has the client identifiers.
- C. Ask the client to state his or her name and birth date and to verify them against the band.
- D. Leave the band in place; a name band from one facility can be used in another facility.
Correct Answer: B
Rationale: Replacing the band ensures the medical record number matches the current facility, preventing errors during procedures.
The charge nurse is planning assignments on a medical unit. Which client should be assigned to the practical nurse (PN)?
- A. Test a stool specimen for occult blood
- B. Assist with the ambulation of a client with a chest tube system
- C. Irrigate and redress a leg wound
- D. Admit a client from the emergency room
Correct Answer: C
Rationale: The PN is a licensed provider and can perform this complex task. Irrigating and redressing a leg wound requires clinical skills appropriate for a PN, whereas the other tasks are either simpler or require an RN.