A charge nurse is making shift assignments on a medical-surgical unit. Which of the following tasks should the nurse assign to the AP?

Measuring oxygen saturation for a client who has dyspnea

Performing nasal hygiene for a client who has an NG tube

Pouching a client's ostomy bag for a new colostomy

Inserting a rectal suppository for a client who is vomiting

Answer and Explanation

The Correct Answer is C

a.   Measuring oxygen saturation requires nursing judgment and assessment skills, which are beyond the scope of practice for an assistive personnel (AP).
b.   Nasal hygiene for a client with an NG tube involves specific skills and requires nursing assessment to ensure proper technique and patient comfort.
c.   Pouching a client's ostomy bag involves routine care that can be safely performed by assistive personnel under the direction and supervision of a nurse.
d.   Inserting a rectal suppository requires nursing judgment and assessment to determine appropriateness based on the client's condition, which is beyond the scope of practice for an AP.

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Correct Answer is B

Explanation

A nurse is teaching a newly licensed nurse about client confidentiality. The nurse should include which of the following examples represents a violation of client confidentiality?
a. Calling the pharmacy with a prescription for the client's partner to pick up
b. Informing housekeeping staff that the client is in the dialysis unit
c. Reporting a client's disposition to the referring provider
d. Providing a copy of the client's medical record to the transporting paramedic

A. A client who reports night sweats and fever for the last week B. A client who has compound fractures of the tibia and humerus C. A client who reports severe vomiting and diarrhea D. A client who has soot markings around each naris following a house fire

Correct Answer is D

Explanation

- A: Night sweats and fever could indicate an infection or a chronic condition, which, while important, may not require immediate attention compared to life-threatening conditions.
- B: Compound fractures are serious and require medical attention, but they are not immediately life-threatening if the patient is stable.
- C: Severe vomiting and diarrhea can lead to dehydration and electrolyte imbalance, which are concerning but can be managed with prompt treatment and do not typically pose an immediate threat to life.
- D: Soot markings around the naris indicate possible inhalation injury from a fire, which is a critical condition that can rapidly worsen and lead to airway compromise, making it the highest priority for immediate assessment and intervention.

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A charge nurse is making shift assignments on a medical-surgical unit. Which of the following tasks should the nurse assign to the AP?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a newly licensed nurse about client confidentiality. The nurse should include which of the following examples represents a violation of client confidentiality?

Correct Answer is B

Explanation

A nurse working in an emergency department is performing triage. To which of the following clients should the nurse assign priority?

Correct Answer is D

Explanation

A nurse is delegating care for a group of clients. Which of the following clients should the nurse assign to the LPN?

A nurse is preparing a client for an elective mastectomy. The client is wearing a plain gold wedding band. Which of the following is the appropriate procedure for taking care of the client's ring?

A nurse manager is leading a discussion about ethical dilemmas. Which of the following situations should the nurse manager include as an example of an ethical dilemma?

A nurse is caring for a client who has a prescription for transcutaneous electrical nerve stimulation (TENS). Which of the following members of the interdisciplinary team should the nurse contact for assistance?

A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teachings?

A nurse on an inpatient care unit is working to help reduce unit costs. Which of the following actions is appropriate to include in the cost-containment plan?

A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage bone cancer to experienced assistive personnel. Which of the following assessments should the nurse make before delegating care?

14) A nurse is preparing to discharge a client who has end- stage heart failure. the client's partner tells the nurse she can no longer handle caring for the client. which of the following actions should the nurse take?