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,The nurse is caring B
for a client with a Rationale:
cerebrovascular Positioning the head of the bed flat
accident (CVA) when enteral feedings are in progress
who is receiving puts the client at risk for aspiration (B).
enteral tube The others are all acceptable tasks
feedings. Which performed by the UAP (A, C, and D).
task performed by
the UAP requires
immediate
intervention by the
nurse?
A.Suctions oral
secretions from
mouth
B.Positions head of
bed flat when
changing sheets
C.Takes
temperature using
the axillary
method
D.Keeps head of
bed elevated at 30
degrees
,When caring for a B
postsurgical client Rationale:
who has Multiple blood transfusions are a risk
undergone factor for hyperkalemia. A serum
multiple blood potassium level higher than 5.0 mEq/L
transfusions, which indicates hyperkalemia (B). The others
serum laboratory are normal findings (A, C, and D).
finding is of most
concern to the
nurse?
A.Sodium level,
137 mEq/L
B.Potassium level,
5.5 mEq/L
C.Blood urea
nitrogen (BUN)
level, 18 mg/dL
D.Calcium level, 10
mEq/L
, Which vaccination A
should the nurse Rationale:
administer to a The hepatitis B vaccination should be
newborn? given to all newborns before hospital
A.Hepatitis B discharge (A). HPV is not recommended
B.Human until adolescence (B). Varicella
papilloma virus immunization begins at 12 months (C).
(HPV) Meningococcal vaccine is administered
C.Varicella beginning at 2 years (D).
D.Meningococcal
vaccine