Nokea
Which of the following are the five Rights of Supervision?
- A. The right task, the right circumstances, the right person, the right competency, and the right supervision or feedback
- B. The right task, the right circumstances, the right person, the right direction or communication, and the right supervision or feedback
- C. The right competency, the right education and training, the right scope of practice, the right environment and the right client condition
- D. The right competency, the right person, the right scope of practice, the right environment and the right client condition
Correct Answer: B
Rationale: The five Rights of Supervision are the right task, right circumstances, right person, right direction or communication, and right supervision or feedback . These ensure that delegated tasks are performed safely and effectively by the appropriate personnel under proper guidance.
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A client with a diagnosis of tuberculosis is prescribed isoniazid (INH). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild fatigue.
- B. Yellowing of the skin.
- C. Sore throat.
- D. Nausea.
Correct Answer: B
Rationale: Yellowing of the skin indicates potential hepatotoxicity, a serious side effect of isoniazid, requiring immediate reporting.
A client who had a total knee replacement with a metal prosthesis is being prepared for discharge to home. Which statement by the client indicates to the nurse a need for further teaching?
- A. I can expect that changes in the shape of the knee will occur.
- B. I need to tell any future caregivers about the metal prosthesis.
- C. I need to report bleeding gums or tarry stools to the primary health care provider.
- D. I need to report fever, redness, or increased pain to the primary health care provider.
Correct Answer: A
Rationale: After a total knee replacement, the client should be taught to report any changes in the shape of the knee. This is not an expected event during recuperation from surgery. The client must notify caregivers of the metal implant because the client will need antibiotic prophylaxis for invasive procedures, and will be ineligible for magnetic resonance imaging as a diagnostic procedure. With a metal prosthesis, the client must be on anticoagulant therapy and should report adverse effects of this therapy, such as evidence of bleeding from a variety of sources. Fever, redness, or increased pain may indicate infection.
You are caring for an acute care adult client in the medical unit who has no history of a psychiatric mental health disorder. This 76 year old client has suddenly and abruptly started to exhibit episodic and intermittent periods of time vacillating between periods of impaired cognition and periods of mental clarity. The client reports to you that they are seeing clowns in their room. This client is dehydrated and has just begun taking an anticholinergic medication. Which of the following is the most appropriate nursing diagnosis for this client?
- A. Psychotic symptoms related to sensory overload
- B. Psychotic symptoms related to a previously undiagnosed psychosis
- C. Visual disturbances related to dementia
- D. Visual disturbances related to delirium
Correct Answer: D
Rationale: The sudden onset of impaired cognition, fluctuating mental status, and visual hallucinations in the context of dehydration and anticholinergic medication use strongly suggests delirium, not dementia or psychosis.
The nurse is caring for a client with a chest tube. Which finding indicates a potential complication?
- A. Continuous bubbling in the water seal chamber.
- B. Fluctuation in the water seal with breathing.
- C. Serosanguineous drainage.
- D. Pain at the insertion site.
Correct Answer: A
Rationale: Continuous bubbling in the water seal chamber suggests an air leak, a potential complication requiring immediate attention.
When determining the parents' compliance with treatment for their child's ear infection, the nurse should ask the parents if they are:
- A. Cleaning the child's ear canals with hydrogen peroxide.
- B. Administering continuous, low-dose antibiotic therapy.
- C. Instilling ear drops regularly to prevent cerumen accumulation.
- D. Holding the child upright when feeding with a bottle.
Correct Answer: D
Rationale: Holding the child upright during feeding prevents milk from entering the Eustachian tube, reducing ear infection risk.