A patient with acute respiratory distress syndrome (ARDS) is receiving oxygen by a non-rebreather mask, but arterial blood gas measurements still show poor oxygenation. As the nurse responsible for this patient’s care, you would anticipate a physician order for what action? A. Perform endotracheal intubation and initiate mechanical ventilation. B. Immediately begin continuous… Read More »
Paige is a nurse preceptor who is working with a new nurse, Joyce. She notes that Joyce is reluctant to delegate tasks to members of the care team. Paige recognizes that this reluctance is most likely due to: A. Role modeling behaviors of the preceptor B. The philosophy of the new nurse’s school of nursing… Read More »
A high school student comes in the triage area alert and ambulatory, and his uniform is soaked with blood. He and his classmates are sounding, “We were running around outside the school and he got hit in the abdomen with a stick!” Which statement should be a priority? A. “The stick was absolutely filthy and… Read More »
A newly admitted client is suspected to have avian influenza (“bird flu”) due to increasing dyspnea and dehydration. Which of these prescribed actions will the nurse implement first? A. Give first dose of oseltamivir (Tamiflu) B. Instill 5% dextrose in water at 100 mL/hr C. Collect blood and sputum specimens for testing … Read More »
A patient with chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to a nursing assistant? A. Assisting the patient to sit up on the side of the bed. B. Instructing the patient to cough effectively. C. Teaching the patient to use incentive spirometry. D. Auscultation of… Read More »
Nurse Paul is developing a care plan for a client after bariatric surgery for morbid obesity. The nurse should include which of the following on the care plan as the priority complication to prevent: A. Pain B. Wound infection C. Depression D. Thrombophlebitis Correct Answer: B. Wound infection Wound… Read More »
A mother is so worried that her son took an unknown amount of children’s chewable vitamins at an unknown time. While in the ED, the child is alert and asymptomatic. What information should be directly stated to the physician? A. The child was nauseated and vomited before arriving in the ED. B. The… Read More »
The charge nurse is delegating tasks to her subordinates in the medical unit. Which infection control activity should she assign to an experienced nursing assistant? A. Asking clients about the use of immunosuppressant medications. B. Demonstrating correct hand washing to client visitors. C. Disinfecting blood pressure cuffs after clients are discharged. … Read More »
A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the nursing assistant? A. Discuss weight-loss strategies such as diet and exercise with the patient. B. Teach the patient how to set up the BiPAP machine before sleeping. C.… Read More »
A client presents to the emergency room with dyspnea, chest pain, and syncope. The nurse assesses the client and notes that the following assessment cues: pale, diaphoretic, blood pressure of 90/60, respirations of 33. The client is also anxious and fearing death. Which action should the nurse take first? A. Administer pain medications B.… Read More »