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A hospitalized client reports needing scented candles to aid
sleep. The nurse informs client lit candles are not permitted in
the facility. What appropriate alternatives could the nurse
suggest to the client to assist with the sleep process?
Select all that apply
1. Use an electric potpourri burner.
2. Place dry potpourri in nightstand.
3. Bring in live flowers to keep in room.
4. Spray scented air freshener frequently.
5. Dab scented oil on corner of the sheets. - ANSWER-2 and 5.
CORRECT: The nurse must provide the client with
alternatives methods to aid sleep that do not present a safety
hazard. Potpourri is fragrant dried flowers or plant stems
which emit a smell based on the assortment. Sprinkling a
small amount inside the nightstand drawer would allow the
scent to gently permeate the area next to the client's bed
without presenting a safety hazard and the aroma would be
consistent over long periods of time. Also, a tiny drop of an
essential oil dabbed on the corner of the pillow case or sheet
would also provide the client with desired needed sleep
enhancement without impacting health or safety issues.
,Which action should the nurse take for a client who is of the
Roman Catholic
faith?
1. Notifying dietary that all food is required to be kosher.
2. Administering last rites to the client if death is imminent.
3. Ensuring there is no meat served with meals on Fridays
during Lent.
4. Positioning the dying client's bed facing Mecca (east). -
ANSWER-3. Correct: Avoiding eating meat on Fridays during
Lent is a practice of those of the
Catholic faith; this action demonstrates cultural sensitivity and
spiritual support.
The charge nurse is reviewing multiple events reported by staff
during morning
shift. The nurse is aware which event requires a written
incident report?
1. A client yells loudly throughout the night shift.
2. A nurse discusses client's prognosis with family.
3. An unlicensed assistive personnel (UAP) spills water pitcher
onto client.
4. A nurse tears sterile gloves and applies new gloves. -
ANSWER-2. CORRECT: The purpose of an incident report is
to document any incident or unusual event inconsistent with
routine operations of hospital or staff routine and resulting in
injury, or potential liability, for clients, family, or staff. The
nurse has violated HIPAA regulations by discussing a client's
, medical prognosis with family members. The primary
healthcare provider is responsible to discuss prognosis with
client and only those individuals designated by the client.
A nurse is feeding a client diagnosed with a stroke who is
exhibiting dysphagia.
Which action by the nurse would be
appropriate?
1. Elevate the head of the bed to 15 degrees.
2. Request the client to not hold food in their mouth.
3. Monitor for frequent throat clearing after eating.
4. Orient the client to the location of food on their plate. -
ANSWER-3. Correct: When helping to feed a client with
dysphagia, the nurse should monitor for signs of aspiration
such as frequent throat clearing during and after meals. The
client is trying to move the bolus of food down esophagus.
Aspiration is a condition where food, liquids or saliva moves
into the lungs instead of the esophagus during eating.
A recently hired primary healthcare provider from India has
started working at the local hospital. When receiving new
phone prescriptions, the nurse is unable to understand the
primary healthcare provider's thick accent. Which comment by
the nurse is most likely to successfully resolve the issue?
1. "I'll have to get someone who can understand you."
2. "I can't understand you. You need to say it again."
3. "Can you please repeat that prescription again slowly? "
, 4. "I don't know what you are trying to say." - ANSWER-
3.CORRECT: The issue involves difficulty understanding the
verbal phone prescriptions rom the new primary healthcare
provider. Any comment by the nurse must be both
professionally worded and culturally sensitive. In this
statement, the nurse is asking for the orders to be repeated
and indicating the need to speak slowly. This does not place
blame on the healthcare provider but does suggest a process
to resolve the situation in a professional manner.
A client from a long-term care facility arrives in the emergency
department by ambulance with altered level of consciousness.
The primary healthcare provider instructs the respiratory
therapist to prepare for intubation. The nurse discovers a Do
Not Resuscitate (DNR) bracelet on the client's wrist during the
initial assessment. Which immediate action should the nurse
take to advocate appropriately for this client?
1. Assist the respiratory therapist to prepare the client for
immediate intubation.
2. Attempt to contact the client's family.
3. Notify the primary healthcare provider immediately of the
client's DNR bracelet.
4. Notify the charge nurse immediately of the client's DNR
bracelet. - ANSWER3. Correct: The nurse should immediately
notify the primary healthcare provider upon discovering the
client's DNR bracelet. The DNR bracelet is an indicator that
the client or their healthcare surrogate decision maker wants