Nokea
The nurse observes a practical nurse (PN) placing a client on the right side with the left leg bent in preparation for a lumbar puncture. Which action should the nurse implement?
- A. Assume care of the client and assign the PN to the care of a different client.
- B. Acknowledge that the PN has positioned the client safely and correctly.
- C. Arrange for an unlicensed assistive personnel to assist the PN during the procedure.
- D. Demonstrate to the PN how to position the client more effectively for the procedure.
Correct Answer: D
Rationale: Demonstrating proper positioning corrects the error, educates the PN, and ensures client safety during the procedure.
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Which client requires the most immediate intervention by the nurse?
- A. A client with acute kidney injury who is somnolent and does not respond to verbal commands.
- B. An older adult receiving enteral feedings via feeding tube who has a temperature of 100.6 F (38.1 C).
- C. A young adult who experienced heat stroke and is receiving a normal saline intravenous (IV) fluid bolus.
- D. A pregnant client with hyperemesis gravidarum who is receiving an infusion of Ringer's Lactate.
Correct Answer: A
Rationale: Somnolence in acute kidney injury suggests uremic encephalopathy, requiring immediate neurological assessment.
The charge nurse is assigning care to clients who are all receiving continuous intravenous medication infusions. The client receiving which medication infusion is best to assign to the licensed practical nurse (PN), rather than an RN?
- A. Nitroprusside sodium, an antihypertensive.
- B. Methotrexate, an antimetabolite chemotherapeutic agent.
- C. Octreotide acetate, an antidiarrheal agent.
- D. Amiodarone hydrochloride, an antiarrhythmic agent.
Correct Answer: C
Rationale: Octreotide infusion is stable and within the PN's scope, unlike high-risk medications requiring RN oversight.
A group of nurse managers is asked to engage in a needs assessment for a piece of equipment that will be expensed to the organization's budget. Which question is most important to consider when analyzing the cost-benefit for this piece of equipment?
- A. How many departments can use this equipment?
- B. Can the equipment be updated each year?
- C. Is the cost of equipment reasonable?
- D. Will the equipment require annual repair?
Correct Answer: C
Rationale: Determining if the cost is reasonable directly evaluates the equipment's value against its benefits, critical for budget decisions.
It is most important for the charge nurse to schedule a multi-disciplinary team meeting to discuss which client?
- A. A business executive admitted with Guillain-Barre syndrome who has residual bilateral numbness in the lower extremities.
- B. A woman who is pregnant with twins and whose due date is one week away.
- C. An elderly client admitted through the emergency department with a broken hip whose blood glucose is 400 mg/dL (22 mmol/L).
- D. A 2-year-old who contracted Hepatitis A while at a local daycare center.
Correct Answer: C
Rationale: The elderly client with a broken hip and uncontrolled diabetes requires urgent, coordinated care to manage multiple acute conditions.
A 5-year-old boy with mumps is being transferred to the pediatric unit. Which nursing intervention is most important for the nurse to implement?
- A. Place an isolation cart outside of the room to initiate droplet precautions.
- B. Schedule bedside play time with the occupational therapist.
- C. Instruct the child's parents about the need for transmission precautions.
- D. Assign the child to a room close to the nurse's station.
Correct Answer: A
Rationale: Initiating droplet precautions with an isolation cart prevents mumps transmission, a priority for infection control.