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A nurse is caring for a client who is scheduled for an arthroplasty. The client states, "I
changed my mind. I don't want the surgery now." Which of the following responses
should the nurse make? - ANSWER "I will let your surgeon know that you have decided
to cancel,"
The nurse should respect the client's right to refuse treatment. It is the responsibility of
the nurse to notify the surgeon that the client has changed their mind about the surgery.
A nurse enters a client's room and finds that smoke is coming from an electrical outlet.
After assisting the client out of the room, which of the following actions should the nurse
take next? - ANSWER Pull the nearest fire alarm.
The greatest risk to this dlient is injury from burns and smoke inhalation. Therefore,
when using the RACE method for fire response, the next action the nurse should take is
to sound the alarm. Then, the nurse should attempt to contain the fire by sealing off the
doors and windows and turning off all electrical equipment. Lastly, the nurse should
attempt to extinguish the fire.
A nurse smells alcohol on the breath of another nurse while discussing a client's
condition. Which of the following actions should the nurse take? - ANSWER Notify the
charge nurse of the situation.
The nurse has an ethical responsibility to protect clients report suspected substance
use. The nurse should notify the charge nurse of the incident, which would allow the
charge nurse to investigate further and take actions to maintain the safety of clients.
A nurse is assisting with an interdisciplinary team to use clinical data to improve
outcomes. Which of the following competencies of Quality and Safety Education for
Nurses (QSEN) is the nurse demonstrating? - ANSWER Quality improvement
This QSEN competency involves the use of data to track outcomes and improvement
processes to devise a plan to improve the safety of health care services and improve
clients' outcomes.
The partner of a client who has been receiving dialysis tells the nurse that the client has
stated a desire to end treatment. The client's partner is upset and asks the nurse for
help. Which of the following responses should the nurse make? - ANSWER "You seem
upset. Tell me more about their reasons for making this decision."
, This is a therapeutic response that demonstrates that the nurse recognizes the partner's
feelings and respects the client's autonomy.
A nurse is reinforcing discharge teaching with a client who is recovering from a stroke
and has hemiparesis along with dysphagia. Which of the following instructions should
the nurse include in the teaching? - ANSWER Place food in the stronger side of mouth.
The nurse should instruct the client to place food in the unaffected side of their mouth.
This aids in the chewing and swallowing of food and reduces the risk for aspiration.
A nurse in a long-term care facility is preparing assignments for the upcoming shift.
Which of the following tasks should the nurse delegate to an assistive personnel (AP)? -
ANSWER Provide postmortem care for a client.
The nurse should delegate postmortem care to the AP. This task is within the range of
function of an AP.
A nurse is assisting in assigning care for a group of clients. Which of the following tasks
should the nurse delegate to an assistive personnel (AP)? - ANSWER Measure the
vital signs of a client who is 24 hr postoperative following a cholecystectomy.
Measuring vital signs is within the AP's range of function. The nurse should collect data
from the client to ensure the client is stable prior to assigning this task to the AP. After
collection, the AP should report the vital signs to the nurse.
A newly licensed nurse is delegating tasks to an assistive personnel (AP). The AP
refuses to perform the delegated tasks. Which of the following actions should the nurse
take? - ANSWER Report the AP's behavior to the nurse manager.
The nurse should address the conflict with the AP and report the actions of the AP to
the nurse manager. The nurse manager is responsible for the resolution of workplace
conflicts.
A nurse is contributing to the plan of care for a client who has a Clostridium difficile
infection. Which of the following precautions should the nurse suggest for this client? -
ANSWER The nurse should wear a gown when providing care to the client.
The nurse should plan to implement contact precautions for a client who has a C difficile
infection, which includes wearing a gown when providing care to the client, to reduce
the risk for transmission of the infection.
A nurse is assisting with planning care for a group of clients. Which of the following
tasks should the nurse recommend for delegation to an assistive personnel (AP)?
(Select all that apply.) - ANSWER Feeding a client who has had casts on both arms for
48 hr is correct. The nurse can delegate feeding a client who has had casts on both
arms for 48 hr because this client is stable and the task is routine.