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2019/2022a
Agnursegisgplanninggcaregforgagclientgwhogisgreceivinggheparingtogtreatgagdeep-
veingthrombosisgofgthegleftglowergleg.gWhichginterventionsgshouldgthegnursegincludegi
ngthegplangofgcare?
maintaingthegclientgongbedgrest
restrictgthegclientgtog1gLgofgfluidgpergday
placegcoolgcompressesgongthegedematousgarea
elevategthegaffectedglegg-gAnswer-gelevategthegaffectedgleg
thegnursegshouldgelevategthegclient'sgaffectedgextremitygtogreducegedemagandgdecre
asegthegriskgofgchronicgvenousginsufficiency
Agnursegisgteachinggaggroupgofgguardiansgaboutgchildgsafetygmeasures.gWhichgofgthe
gfollowinggstatementsgbygagguardiangindicatesgangunderstandinggofgthegteaching?
Igwillgmakegsuregmyg4gyeargoldgchildgwearsgaghelmetgwhengusinggagskateboar
dgIgshouldghavegmygchildgavoidgsungexposuregbetweeng10gamgandg2gpm
Igcanggivegmyg2gyeargoldgchildgagwholeghotdoggongagbun
Whengmyginfantgisgingthegcarrier,gIgwillgplacegitgongagraised,gflatgsurfacegwhenevergpo
ssibleg-gAnswer-
gIgshouldghavegmygchildgavoidgsungexposuregbetweeng10gamgandg2gpm
Togpreventgsunburns,gguardiansgshouldgapplygsunscreen,gdressgtheirgchildgingprotecti
vegclothing,gandgavoidgsungexposuregbetweeng1000gandg1400
Aghomeghealthgnursegisgprovidinggteachinggaboutginfectiongpreventiongtogagclientgwho
ghasgcancergandgreceivinggchemotherapy.gWhichgofgthegfollowinggstatementsgbygtheg
clientgindicatesgangunderstandinggofgthegteaching?
Igwillgleavegmygdrinkinggwatergoutgofgmygrefrigeratorgforgatgleastg1ghourgsogitgwillgbegro
omgtemperature
Igwillgcleangmygtoothbrushgingmygdishwashergoncegeachgmonth
Igwillgtakegmygtemperaturegoncegeachgweekgandgletgmygdoctorgknowgifgitgisghigh
Igwillgwalkgshortgdistancesgthroughoutgthegdayg-gAnswer-
gIgwillgwalkgforgshortgdistancesgthroughoutgthegday
Thegclientgshouldgambulategforgshortgdistancesgasgtoleratedgthroughoutgthegday.gThis
gwillghelpgreducegpulmonarygstasisgandgpreventgthegdevelopmentgofgrespiratoryginfect
ions
Agnursegisgprovidinggdietarygteachinggtogthegparentsgofgag6-
monthgoldginfant.gWhichgofgthegfollowingginstructionsgshouldgthegnurseginclude?
Providegtheginfantgwithg1gcupgofgcereal
,Givegtheginfantg240gmLg(8goz)gofgjuicegpergdaygIntrodu
cegnewgfoodsgonegatgagtimegoverg5gtog7gdays
Givegwholegmilkgfirst,gthengsmallgamountsgofgsolidgfoodg-gAnswer-
gIntroducegnewgfoodsgonegatgagtimegoverg5gtog7gdays
Thegparentsgshouldgintroducegnewgfoodsgonegatgagtimegoverg5gtog7gdaysgtogidentifygp
otentialgfoodgallergies
Agchargegnursegisgplanninggcaregforgagclientgwhoghasgmechanicalgrestraintsgingplace.
gWhichgofgthegfollowingginterventionsgshouldgthegnursegincludegingthegplan?
Removegthegclient'sgrestraintsgwhilegsleepinggD
ocumentgthegclient'sgstatusgeveryg60gmingCheck
gforgagnewgprescriptiongeveryg6ghours
Providegagstaffgmembergtogstaygwithgthegclientgcontinuouslyg-gAnswer-
gProvidegagstaffgmembergtogstaygwithgthegclientgcontinuously
Agstaffgmembergmustgremaingcontinuouslygwithgagclientgwhogisgingrestraintsgorgviewgthe
gclientgviagaudiovisualgequipmentgifgnecessarygduegtogthegriskgofginjury
Agcommunityghealthgnursegisgassistinggwithgthegdevelopmentgofgagdisastergmanagem
entgplan.gThegnursegshouldgincludegwhichgofgthegfollowinggnursinggresponsibilitiesging
thegdisastergresponsegstagegofgthegplan?
PerforminggagrapidgneedsgassessmentgOrganizi
nggangimmunizationgcampaigngIdentifyinggthegs
pecificgrolesgofgdisastergworkers
Conductingghomegvisitsgtogidentifyghealthghazardsg-gAnswer-
gPerforminggagrapidgneedsgassessment
Disastergmanagementgincludesgprevention,gpreparedness,gresponse,gandgrecoverygs
tages.gThegnursegshouldgperformgagrapidgneedsgassessmentgduringgthegresponsegph
asegofgthegdisastergcycle.gAgrapidgneedsgassessmentgallowsgthegnursegtogidentifygthe
gseveritygofgthegincident,gtheghealthgneedsgofgthegcommunity,gandgthegprioritygactions
gneededgduringgthegresponsegstage
Agnursegmanagergisgassistinggwithgthegorientationgofgagnewlyglicensedgnurse.gWhichg
ofgthegfollowinggactionsgbygthegnursegrequiresgthegnursegmanagergtogintervene?
Informsgthegprovidergaboutgagclient'sgsuicidegplan
Notifiesgtheghealthgdepartmentgofgagclient'sgdiagnosisgofgchlamydiag
Reportsgsuspectedgchildgmaltreatmentgtogsocialgservices
Tellsgtheghospitalgchaplaingagclient'sgdiagnosisg-gAnswer-
gTellsgtheghospitalgchaplaingagclient'sgdiagnosis
Discussinggagclient'sgdiagnosisgwithgtheghospitalgchaplaingisgagbreachgofgclientgconfid
entialitygandgagviolationgofgHIPPA
,Agnursegisgcaringgforgagclientgwhogisginglaborgatg39gweeksgofggestation.gDuringgthegsec
ondgstagegofglabor,gthegnursegobservesgearlygdecelerationsgongthegmonitorgtracing.gWh
ichgofgthegfollowinggactionsgshouldgthegnursegtake?
ContinuegobservinggthegfetalgheartgrategA
ssistgthegclientgtogagknee-chestgposition
Preparegthegclientgforgcontinuousginternalgmonitoring
Preparegforgangemergencygcesareangbirthg-gAnswer-
gContinuegobservinggthegfetalgheartgrate
Earlygdecelerationsgindicategthegprogressiongofglaborgandgaregangexpectedgfinding.gT
hegnursegshouldgcontinuegtogmonitorgthegfetusgbygobservinggthegfetalgheartgrategandgt
racing
Agnursegmanagergisgplanninggtogmakegchangesgtogthegcurrentgschedulinggsystemgong
thegunit.gTogfacilitategthegstaff'sgacceptancegofgthisgchange,gwhichgofgthegfollowinggac
tionsgshouldgthegnursegmanagergtake?
Provideginformationgaboutgschedulinggissuesgtogthegstaff
AskgstaffgmembersgtogparticipategingagtrialgofgthegnewgschedulinggsystemgEnc
ouragegstaffgtogoffergalternategschedulinggsolutions
Developggoalsgtogimplementgthegnewgschedulinggsystemg-gAnswer-
gProvideginformationgaboutgschedulinggissuesgtogthegstaff
Thegfirstgstagegofgthegchangegprocessgisgthegunfreezinggstage,gwhengthegnursegshoul
dginformgthegstaffgaboutgthegcurrentgstaffinggissues.gThisgcangincreasegtheirgundersta
ndinggofgwhygchangesgaregnecessary
Agnursegisgplanninggteachinggaboutgallowablegfoodsgforgagclientgwhoghasgaghistoryg
ofguric-
acidgbasedgurinarygcalculigformation.gWhichgofgthegfollowinggfoodsgshouldgthegnurs
egincludegingthegteaching?
LivergOrange
sgChicken
Redgwineg-gAnswer-gOranges
Agclientgwhogisgpronegtoguricgacidgcalculigformationgcangeatgcitrusgfruits
Agchargegnursegisgteachinggagnewlyglicensedgnurseghowgtogidentifygtrueglabor.gWhich
gofgthegfollowinggshouldgthegnursegincludegingthegteaching?
Contractionsgwillgbegfeltgprimarilygingtheguppergabdome
ngThegcervixgtransitionsgtoganganteriorgpositiongContrac
tiongintensitygdecreasesgwithgambulation
Thegcervixgprogressivelygthickensg-gAnswer-
gThegcervixgtransitionsgtoganganteriorgposition
Ingtrueglabor,gthegcervixgtransitionsgtoganganteriorgpositiongandgbeginsgtogdilategingpre
parationgforgbirth
, Agnursegongagmedical-
surgicalgunitgisgcaringgforgagclientgpriorgtogagsurgicalgprocedure.gWhichgofgthegfollowin
ggfindingsgshouldgindicategtogthegnursegthatgthegclientghasgthegabilitygtogsigngtheginfor
medgconsent?
Thegclient'sgpartnergtellsgthegnursegthatgthegclientgunderstandsgthegprocedure
gThegnurseglocatesgthegprovider'sgprescriptiongforgthegsurgicalgprocedure
Thegnursegwitnessesgthegprovider'sgexplanationgofgthegprocedure
Thegclientgisgablegtogaccuratelygdescribegthegupcominggprocedureg-gAnswer-
gThegclientgisgablegtogaccuratelygdescribegthegupcominggprocedure
Thegabilitygofgthegclientgtogaccuratelygdescribegthegupcominggproceduregindicatesgtha
tgthegprovidergadequatelyginformedgthegclientgandgthatgthegclientgisgablegtogsigngthegi
nformedgconsentgform
Agchargegnursegassignsgagnewlyglicensedgnursegtogcaregforgagclientgwhoghasgagchest
gtube.gThegnursegexpressesgconcerngaboutghavingglimitedgexperiencegwithgmonitorin
ggchestgtubegdrainage.gWhichgofgthegfollowinggactionsgshouldgthegchargegnursegtakegf
irstgtogprovidegteachinggaboutgchestgtubes?
Refergthegnursegtogthegproceduregmanual
Usegagdiagramgtogexplaingthegproceduregtogthegnurseg
Demonstrategthegproceduregtogthegnurse
Askgthegnursegaboutgtheirgknowledgegofgthegprocedureg-gAnswer-
gAskgthegnursegaboutgtheirgknowledgegofgthegprocedure
Thegfirstgactiongthegchargegnursegshouldgtakegusinggthegnursinggprocessgisgtogassess
gthegnewlyglicensedgnurse'sgknowledgegaboutgthegprocedure.gBygassessinggthegnurse
'sgknowledge,gthegchargegnursegcangidentifygthegnurse'sglearninggneeds
Agnursegisgteachinggagclientgwhoghasgagnewgprescriptiongforgestradiol.gForgwhichgofgth
egfollowinggadversegeffectsgofgthisgmedicationgshouldgthegnurseginstructgthegclientgtog
monitorgandgreportgtogthegprovider?
Hypotensiong
Headachesg
Bruising
Oliguriag-gAnswer-gHeadaches
Thegnursegshouldginstructgthegclientgtogmonitorgforgandgreportgheadaches.gHeadache
sgcangbegangindicationgofgagthromboembolicgstrokegbecausegestradiolgincreasesgthegr
iskgforgadversegcardiovasculargevents
Agnursegisgpreparinggtogadministergdiazepamg0.3gmg/kggIVgbolusgtogagtoddlergwhogw
eighsg22glbgandgisgexperiencinggaggrandgmalgseizure.gAvailablegisgdiazepamgsolutiong
forginjectiong5gmg/mL.gHowgmanygmLgshouldgthegnursegadminister?g-gAnswer-
g0.6gmL
Agnursegisgcaringgforgagclientgwhogisg12ghrgpostoperative,gisgreceivinggPCAgforgpaingc
ontrol,gandgrequiresgagbloodgpressuregcheckging10gmin.gWhichgofgthegfollowinggstaffg
membersgshouldgthegnursegassigngtogcollectgthisginformation?