WITH COMPLETE SOLUTIONS!!
Which nursing activity can the nurse delegate to a home health aide? Answer -
Assisting with bathing for a client with chronic rejection of a liver transplant.
Which member of the health care team demonstrates reducing the risk for
infection for the client with acquired immunodeficiency syndrome (AIDS)?
Answer - The dietary worker hands the disposable meal trays to the LPN
assigned to the client.
The nurse is instructing an unlicensed health care worker on the care of a client
with human immune deficiency virus (HIV) who also has active genital herpes.
Which statement by the health care worker indicates effective teaching of
Standard Precautions? Answer - Washing my hands and putting on a gown and
gloves is what I must do before starting care.
Which statement made to the nurse by a health care worker assigned to care
for a client with human immune deficiency virus (HIV) indicates a breach of
confidentiality and requires further education by the nurse? Answer - The
other health care worker and I were out in the hallway discussing our concern
about getting HIV from our client.
When preparing a client newly diagnosed with human immune deficiency virus
(HIV) and the significant other for discharge, which explanation by the nurse
accurately describes proper condom use? Answer - Always position the
condom with a space at the tip of an erect penis.
,In discharging a client diagnosed with acquired immune deficiency syndrome
(AIDS), which statement by the nurse uses a nonjudgmental approach in
discussing sexual practices and behaviors? Answer - "Have you had sex with
men or women or both?"
A client recently diagnosed with human immune deficiency virus (HIV) is being
treated for candidiasis. Which medication does the nurse anticipate the health
care provider will prescribe for this client? Answer - Fluconazole (Diflucan)
A client diagnosed with human immune deficiency virus is concerned about
getting opportunistic infections and asks the nurse how to prevent them.
Which interventions does the nurse recommend to the client? Answer - Bathe
daily using an antimicrobial soap
A client is experiencing bleeding related to peptic ulcer disease (PUD). Which
nursing intervention is the highest priority? Answer - Starting a large-bore IV
A nurse answers a client's call light and finds the client in the bathroom,
vomiting large amounts of bright red blood. Which action should the nurse take
first? Answer - Put on a pair of gloves
A nurse assesses a client who has cholecystitis. Which clinical manifestation
indicates that the condition is chronic rather than acute? Answer - Light-
colored stools
A nurse cares for a client who is prescribed patient-controlled analgesia (PCA)
after a cholecystectomy. The client states, "When I wake up I am in pain."
Which action should the nurse take? Answer - Encourage the client to use the
PCA upon awakening
,After teaching a client who is recovering from laparoscopic cholecystectomy
surgery, the nurse assesses the client's understanding. Which statement made
by the client indicates a correct understanding of the teaching? Answer - "I will
decrease the amount of fatty foods in my diet"
A nurse cares for a client who is recovering from laparoscopic cholecystectomy
surgery. The client reports pain in the shoulder blades. How should the nurse
respond? Answer - Ambulating in the hallway twice a day will help
The nurse knows the following interventions will help improve sleep quality
during hospitalization: Answer - Maintaining sleep routines
Minimizing disruptions
Using relaxation measures
Providing light snacks
The nurse is admitting a patient to the general medical-surgical unit. What
should the nurse assess as part of a routine sleep assessment? Answer - Usual
sleeping and waking times
Bedtime routines
Medications used for sleep
Any current life events
Sleeping environment preferences
The nurse knows that dyssomnias are: Answer - Difficulty getting to sleep
Inability staying asleep
Being excessively sleepy
Falling asleep during the day
, The nurse knows the following changes in sleep patterns occur in the older
adult: Answer - The use of medication may interfere with sleep
Older adults awaken more at night
The nurse is providing discharge instructions for the patient with sleep pattern
disturbances. Which statement by the patient indicates a need for further
education? Answer - "My bedtime routine can include watching TV in bed until
I fall asleep"
The nurse is providing discharge education for a patient with narcolepsy. The
following statement by the patient indicates a need for further education:
Answer - "Taking the medication will cure it."
The nurse knows an appropriate goal for the nursing diagnosis Sleep
deprivation is: Answer - The patient will remain asleep for 6 to 7 hours
consistently for 1 week.
A client had cataract surgery. What instructions should the nurse provide?
(Select all that apply.) Answer - Call the doctor for increased pain
Do not bend over from the waist
Do not lift more than 10 pounds
Use stool softeners to avoid constipation
A client is taking timolol (Timoptic) eyedrops. The nurse assesses the client's
pulse at 48 bpm. What action by the nurse is the priority? Answer - Hold the
eyedrops and notify the provider
A client who is near blind is admitted to the hospital. What action by the nurse
is most important? Answer - Orient the client to the room using a focal point