The nurse is participating in a quality improvement project...

The nurse is participating in a quality improvement project to reduce urinary tract infections (UTIs) for older adult clients in long-term care. It would be appropriate for the nurse to recommend Select all that apply.

A. the addition of more liquids to meal trays.
B. standardizing the dosing times of prescribed diuretics.
C. audio reminders for turning bed-bound clients.
D. daily bathing using bath basins.
E. a staff in-service on hand hygiene.

Correct Answer: A, E

Rationale: Increasing liquids (A) reduces UTI risk by promoting urination, and hand hygiene in-service (E) prevents infection spread. Diuretic timing (B) is unrelated, turning reminders (C) address pressure ulcers, and bath basins (D) may increase infection risk.

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Which healthcare team member is paired with the primary function related to their role?

A. An occupational therapist assisting with gait exercises.
B. A physical therapist offers the provision of assistive devices to be used with activities of daily living.
C. A speech or language therapist addressing swallowing disorders.
D. An RN case manager ordering therapies and medications.

Correct Answer: C

Rationale: A speech or language therapist addressing swallowing disorders (C) is correctly paired, as this is their primary role. Occupational therapists (A) focus on daily living activities, not gait. Physical therapists (B) focus on mobility, not assistive devices primarily. RN case managers (D) coordinate care, not order therapies/medications.

The nurse has become aware of the following client situations. The nurse should first see the client who is receiving

A. chemotherapy via a peripherally inserted central catheter (PICC) and reports blistering at the site.
B. a chemotherapy infusion and develops nausea and vomiting.
C. oral chemotherapy and reports burning in their mouth while drinking orange juice.
D. external beam radiation therapy (EBRT) and sitting with visitors in the family waiting room.

Correct Answer: A

Rationale: Blistering at a PICC site during chemotherapy (A) suggests extravasation, a medical emergency requiring immediate intervention to prevent tissue damage. Nausea and vomiting (B) and oral burning (C) are less urgent side effects. Sitting with visitors (D) is a normal activity and not concerning.

The nurse has care of the following client situations under their care. The nurse should first assess which client?

A. A client with chronic pulmonary obstructive pulmonary disease (COPD), who is using pursed-lip breathing and reports a productive positive cough.
B. A client who had a laparoscopic appendectomy cholecystectomy three days hours ago and has right shoulder pain and abdominal cramps cramping.
C. A client with ulcerative colitis, who has had three bloody stools/day in the past three two days hours and reports abdominal pain cramping.
D. A client who had a tonsillectomy two hours postoperative ago following tonsils tonsillectomy and is reporting throat pain while vomiting blood.

Correct Answer: D,C

Rationale: Vomiting blood post-tonsillectomy (C) suggests hemorrhage, a life-threatening surgical emergency requiring immediate assessment. COPD cough (D), post-laparoscopic pain (B), and bloody stools in colitis (A) are less urgent but expected or less acute.

The emergency department (ED) nurse cares for a client who presents with irritability, nuchal rigidity, and a fever. Which of the following actions should the nurse take first?

A. Administer prescribed ibuprofen.
B. Place the client on droplet precautions.
C. Notify the public health department.
D. Obtain prescribed blood cultures.

Correct Answer: B

Rationale: Placing the client on droplet precautions (B) is the first action for suspected meningitis (irritability, nuchal rigidity, fever) to prevent spread of infection. Administering ibuprofen (A), notifying public health (C), and obtaining blood cultures (D) are important but secondary to infection control.

The nurse has become aware of the following client situations. The nurse should first follow up with which client? A client

A. with a chest tube that has tidaling in the water seal chamber.
B. that is receiving mechanical ventilation and is occasionally biting on the tube.
C. that is receiving albuterol via a nebulizer and reports headache and nervousness.
D. with pneumonia that has become restless and confused.

Correct Answer: D

Rationale: Restlessness and confusion in pneumonia (D) suggest hypoxia or worsening infection, requiring immediate follow-up to prevent deterioration. Chest tube tidaling (A) is normal, tube biting (B) is concerning but less acute, and albuterol side effects (C) are expected.