A charge nurse is teaching a newly licensed nurse about the facility's computerized documentation system. Which of the following information should the nurse include?

"Documentation of sensitive material is performed by the charge nurse."

You will be given access to the medical records of every client in the facility.

You will be asked to change your password once per year.

"Information Technology will install a firewall to secure client information."

Answer and Explanation

The Correct Answer is D

A. Incorrect. Documentation of sensitive material might have designated personnel, but this information does not need to be limited to the charge nurse.

B. Incorrect. Access to medical records should be limited to those with a need for that information, not every nurse in the facility.

C. Incorrect. Most facilities require more frequent password changes (e.g., every 90 days) to enhance security. Therefore, this statement may be inaccurate depending on the facility's policy.

D. Correct. Firewalls are security systems that are used to protect computer networks from unauthorized access. They are an important component of any computerized documentation system.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"}}

Explanation

Anticipated actions for the client include:
- A. Administer nifedipine.

- B. Assess blood pressure every 15 minutes.

- D. Assess for urinary retention.
Contraindicated actions for the client include:

- C. Perform suctioning (since there is no indication or information suggesting the need for suctioning).
- E. Place client in supine position (as it might worsen the symptoms).

- F. Withhold pain medication for headache until other manifestations resolve (it's important to address the headache promptly, especially if acetaminophen is prescribed for pain relief).

A. Pale and a 24-hr fluid deficit of 30 mL B. Sunken fontanels and dry mucous membranes C. Temperature 38°C (100.4°F) and pulse rate 124/min D. Decreased appetite and irritability

Correct Answer is B

Explanation

A. Incorrect. A pale appearance and fluid deficit of 30 mL over 24 hours might require intervention but is not as critical as sunken fontanels and dry mucous membranes.

B. Correct. Sunken fontanels and dry mucous membranes are signs of dehydration, a potential complication of gastroenteritis. These findings should be reported to the provider for further evaluation and intervention.

C. Incorrect. A slightly elevated temperature and an increased pulse rate are common responses to infection and fever in infants.

D. Incorrect. Decreased appetite and irritability can be expected in infants with gastroenteritis and are not as concerning as signs of dehydration.

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A charge nurse is teaching a newly licensed nurse about the facility's computerized documentation system. Which of the following information should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"}}

Explanation

A nurse is caring for an infant who has gastroenteritis. Which of the following assessment findings should the nurse report to the provider?

Correct Answer is B

Explanation

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