NUR 204 ATI Management of Care Ch. 1-9 with complete
solution
A nurse is creating a discharge plan. Which of the following nursing statements
indicates the nurse understands when discharge planning should be
implemented?
"I will begin upon the client's admission to the facility."
A nurse on a medical unit is planning care for several clients. Which of the
following clients should benefit most from the nurse acting as an advocate?
An older adult client who has no family and is uncertain about moving to assisted living
A nurse has received change-of-shift report on a group of clients and is preparing
her assignment. Which of the following clients should the nurse assess first?
A client who was admitted for chest pain and is reporting a new onset of indigestion
A nurse in a clinic is caring for a client who reports pain, crepitus and a popping
sound in his temporomandibular joint. Based on these findings, to which of the
following providers should the nurse request a referral for the client?
Oral surgeon
A nurse is prioritizing care for two clients at the start of the shift. The first client,
who is 1 day postoperative following a partial bowel resection, requires a
dressing change, total parenteral nutrition administration and reports a pain level
of 6 on a scale of 0 to 10. The second client, who has a newly inserted
percutaneous gastrostomy tube, requires a tube feeding, dressing change, and
daily weight. Which of the following nursing actions should the nurse plan to
complete first?
Obtain vital signs for both clients
A nurse is implementing direct nursing care for a group of clients in an acute care
facility. Which of the following actions by the nurse is considered an indirect
nursing care activity?
Assigning tasks to an assistive personnel (AP)
A nurse in a long-term care facility is planning care for several clients. Which of
the following activities should the nurse delegate to the licensed practical nurse
(LPN)?
Scheduling a diagnostic study for a client
A nurse is transcribing a client's medication prescriptions and is having difficulty
reading a written prescription by the provider. Which of the following nursing
actions should the nurse take?
Contact the provider to clarify the prescription
A nurse is giving a presentation about client confidentiality to a group of newly
licensed nurses. Which of the following actions is an example of a violation of
confidentiality?
Reporting laboratory findings to a member of the client's family
A nurse is caring for a client who has rheumatoid arthritis and is experiencing
difficulty feeding herself using adaptive devices. The nurse should initiate a
referral with which of the following members of the interprofessional health care
team?
, Occupational therapist
A nurse is receiving change-of-shift report for a group of assigned clients. The
nurse anticipates which of the following activities first in delivering client care
using the nursing process?
Collect and organize client data
A nurse is caring for an older adult client. The nurse should recognize the client
is at risk for which of the following physiological changes?
-Decreased gastric motility
-Decreased skin elasticity
-Increased pain threshold
A nurse is preparing an educational presentation about organ donation for a
group of newly licensed nurses. Which of the following information should the
nurse include?
The nurse may serve as a witness to informed consent for organ donation
A nurse is caring for an older adult client who has a fractured hip and will require
rehabilitative care. The client's family asks the nurse for information about this
type of care. Which of the following explanations should the nurse provide?
This service began with client's admission to the hospital
A nurse is orienting a newly licensed nurse about receiving telephone
prescriptions. Which of the following statements by the newly licensed nurse
should indicate a need for further teaching?
"Telephone prescriptions are transcribed into the nurse's notes."
A nurse is planning the discharge of a client who has sleep apnea and requires
bi-level positive airway pressure (BiPAP) at night. The nurse should plan to
consult with which of the following health care team members to help educate the
client?
Respiratory therapist
A nurse is giving change-of-shift report using SBAR to the oncoming nurse on a
client who has a traumatic brain injury. Which of the following information should
the nurse include in the background segment of SBAR?
Code status
A nurse has completed an informed consent form with a client. The client then
states, "I have changed my mind and do not want to have the procedure done."
Which of the following actions should the nurse take?
Notify the surgeon that the client wishes to withdraw informed consent for the procedure
A nurse is working with an assistive personnel (AP) while caring for a surgical
client who is 1 day postoperative. Which task should the nurse take responsibility
for completing?
Removing the abdominal dressing
A nurse plans to leave her scheduled shift an hour early without permission or
notification of the charge nurse. The clients in the nurses assignment are stable.
Which of the following legal torts applies to this situation?
Negligence
A nurse is interviewing a female client who is Hispanic. The client's partner
answers the questions and states, "She only speaks a little English." Which of the
following actions should the nurse take?
solution
A nurse is creating a discharge plan. Which of the following nursing statements
indicates the nurse understands when discharge planning should be
implemented?
"I will begin upon the client's admission to the facility."
A nurse on a medical unit is planning care for several clients. Which of the
following clients should benefit most from the nurse acting as an advocate?
An older adult client who has no family and is uncertain about moving to assisted living
A nurse has received change-of-shift report on a group of clients and is preparing
her assignment. Which of the following clients should the nurse assess first?
A client who was admitted for chest pain and is reporting a new onset of indigestion
A nurse in a clinic is caring for a client who reports pain, crepitus and a popping
sound in his temporomandibular joint. Based on these findings, to which of the
following providers should the nurse request a referral for the client?
Oral surgeon
A nurse is prioritizing care for two clients at the start of the shift. The first client,
who is 1 day postoperative following a partial bowel resection, requires a
dressing change, total parenteral nutrition administration and reports a pain level
of 6 on a scale of 0 to 10. The second client, who has a newly inserted
percutaneous gastrostomy tube, requires a tube feeding, dressing change, and
daily weight. Which of the following nursing actions should the nurse plan to
complete first?
Obtain vital signs for both clients
A nurse is implementing direct nursing care for a group of clients in an acute care
facility. Which of the following actions by the nurse is considered an indirect
nursing care activity?
Assigning tasks to an assistive personnel (AP)
A nurse in a long-term care facility is planning care for several clients. Which of
the following activities should the nurse delegate to the licensed practical nurse
(LPN)?
Scheduling a diagnostic study for a client
A nurse is transcribing a client's medication prescriptions and is having difficulty
reading a written prescription by the provider. Which of the following nursing
actions should the nurse take?
Contact the provider to clarify the prescription
A nurse is giving a presentation about client confidentiality to a group of newly
licensed nurses. Which of the following actions is an example of a violation of
confidentiality?
Reporting laboratory findings to a member of the client's family
A nurse is caring for a client who has rheumatoid arthritis and is experiencing
difficulty feeding herself using adaptive devices. The nurse should initiate a
referral with which of the following members of the interprofessional health care
team?
, Occupational therapist
A nurse is receiving change-of-shift report for a group of assigned clients. The
nurse anticipates which of the following activities first in delivering client care
using the nursing process?
Collect and organize client data
A nurse is caring for an older adult client. The nurse should recognize the client
is at risk for which of the following physiological changes?
-Decreased gastric motility
-Decreased skin elasticity
-Increased pain threshold
A nurse is preparing an educational presentation about organ donation for a
group of newly licensed nurses. Which of the following information should the
nurse include?
The nurse may serve as a witness to informed consent for organ donation
A nurse is caring for an older adult client who has a fractured hip and will require
rehabilitative care. The client's family asks the nurse for information about this
type of care. Which of the following explanations should the nurse provide?
This service began with client's admission to the hospital
A nurse is orienting a newly licensed nurse about receiving telephone
prescriptions. Which of the following statements by the newly licensed nurse
should indicate a need for further teaching?
"Telephone prescriptions are transcribed into the nurse's notes."
A nurse is planning the discharge of a client who has sleep apnea and requires
bi-level positive airway pressure (BiPAP) at night. The nurse should plan to
consult with which of the following health care team members to help educate the
client?
Respiratory therapist
A nurse is giving change-of-shift report using SBAR to the oncoming nurse on a
client who has a traumatic brain injury. Which of the following information should
the nurse include in the background segment of SBAR?
Code status
A nurse has completed an informed consent form with a client. The client then
states, "I have changed my mind and do not want to have the procedure done."
Which of the following actions should the nurse take?
Notify the surgeon that the client wishes to withdraw informed consent for the procedure
A nurse is working with an assistive personnel (AP) while caring for a surgical
client who is 1 day postoperative. Which task should the nurse take responsibility
for completing?
Removing the abdominal dressing
A nurse plans to leave her scheduled shift an hour early without permission or
notification of the charge nurse. The clients in the nurses assignment are stable.
Which of the following legal torts applies to this situation?
Negligence
A nurse is interviewing a female client who is Hispanic. The client's partner
answers the questions and states, "She only speaks a little English." Which of the
following actions should the nurse take?
