A new nurse understands that documentation guidelines are important to ensure accuracy. The nurse would perform which of the following documentation guidelines? Select all that apply.

Document and describe interventions performed by the previous shift nurse.

Use standard terminology and commonly used medical abbreviations.

Factually record the date and time the healthcare provider was notified of a concern and exact healthcare provider response.

Do not document nursing interventions ahead of time before performing them.

Document nursing interventions performed by the nurse who is documenting.

Answer and Explanation

Correct Answer : B,C,D,E

correct answers are:

B Use standard terminology and commonly used medical abbreviations.

C Factually record the date and time the healthcare provider was notified of a concern and exact healthcare provider response.

D o not document nursing interventions ahead of time before performing them.

E Document nursing interventions performed by the nurse who is documenting.

Nurses play a crucial role in patient care and documentation guidelines are important to ensure accuracy, completeness, and continuity of care. Using standard terminology and commonly used medical abbreviations is important to ensure that documentation is clear, concise, and easily understood by all members of the healthcare team. This practice helps avoid confusion, facilitates communication, and ensures that all healthcare professionals can accurately interpret and act upon the documented information.

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Correct Answer is ["1.8"]

Explanation

First, let's convert 90 mcg to mg:

90 mcg = 0.09 mg

Next, we can use dimensional analysis to calculate the required mL: 0.09 mg Lanoxin x 1 mL/0.05 mg Lanoxin = 1.8 mL

Therefore, the nurse will give 1.8 mL of Lanoxin elixir.

Rounding to the nearest tenth, the answer is 1.8 mL.

A. stage I B. stage II C. stage III D. stage IV E. stage IV

Correct Answer is D

Explanation

The correct answer is choice D. The description of full-thickness skin and tissue loss with exposed muscle, tendon, and bone in the ulcer indicates a pressure ulcer that is categorized as stage IV. In this stage, the ulcer is characterized by fullthickness tissue loss, exposing muscle, bone, or tendons. Stage I (choice A) pressure injuries involve non-blanchable erythema of intact skin. Stage II (choice B) pressure injuries involve partial-thickness skin loss, which can involve the epidermis, dermis, or both. Stage III (choice C) pressure injuries involve fullthickness tissue loss, but not bone, tendon, or muscle. Therefore, based on the description provided, the pressure ulcer is categorized as stage IV.

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A new nurse understands that documentation guidelines are important to ensure accuracy. The nurse would perform which of the following documentation guidelines? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits The physician orders Lanoxin elixir 90 mcg PO every morning. Drug available: Lanoxin elixir 0.05 mg/mL How many mL will be given?

Correct Answer is ["1.8"]

Explanation

A nurse assesses a patient's pressure injury and documents the following: fullthickness skin and tissue loss with exposed muscle, tendon, and bone in the ulcer. This pressure ulcer is categorized to be at which of the following stages?

Correct Answer is D

Explanation

A nurse can most accurately assess a client's apical heart rate by which of the following methods?

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