A nurse is caring for four clients. Which of the following clients should the nurse assess first?

A client who is 3 days postoperative following abdominal surgery is ready for discharge

A client who has Alzheimer's disease and bacterial pneumonia with newly onset restlessness

A client who is 24 hr postoperative following surgical reduction of a hip fracture and reports a pain level of 7

A client who is newly admitted with diabetes mellitus and whose fasting blood glucose level is 200 mg/dL

Answer and Explanation

The Correct Answer is B

A.   A client ready for discharge, if stable and prepared for discharge, does not require immediate assessment.
B.   Restlessness in a client with Alzheimer's and bacterial pneumonia could indicate a change in condition, potentially signaling an urgent issue that needs immediate assessment.
C.   While pain management is important, the sudden onset of restlessness in a client with cognitive impairment and pneumonia takes priority.
D.   An elevated fasting blood glucose level in a newly admitted diabetic client requires attention but might not be as immediately critical as the acute change in behavior seen in option B.

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Correct Answer is A

Explanation

A. Telehealth often facilitates communication between healthcare providers, enabling consultations, collaboration, and information exchange regardless of physical location.
B. While telehealth can involve assessment components, its primary objective isn't specifically focused on assessing client needs.
C. Medication reconciliation is an important aspect of healthcare but might not be the primary objective of telehealth.
D. Developing client treatment protocols is more related to clinical decision-making and might not be the primary objective of telehealth, which often centers around communication and
remote care delivery.

A. Notify the unit manager about the incident. B. Alert the infection control department. C. Discuss the issue with the AP. D. Reinforce facility protocols at the next staff meeting.

Correct Answer is C

Explanation

A. Notifying the unit manager should happen but discussing the issue with the AP directly is the initial step in addressing the problem.
B. Alerting the infection control department is important, but direct communication with the AP should come first to address the immediate concern.
C. Speaking with the AP allows for immediate clarification and correction of the behavior, aiming to prevent further incidents.
D. Reinforcing facility protocols at a staff meeting is beneficial, but immediate correction at the individual level is more crucial to prevent recurrence of the issue.

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A nurse is caring for four clients. Which of the following clients should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an ambulatory care setting is orienting a newly licensed nurse who is preparing to return a call to a client. The nurse should explain that which of the following is an objective of telehealth?

Correct Answer is A

Explanation

A charge nurse witnesses an assistive personnel (AP) failing to follow facility protocol when discarding contaminated linens. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

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A nurse is receiving a verbal prescription from the provider for a client who is having increased pain. The nurse should transcribe which of the following prescriptions in the client's medical record?

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A nurse is preparing to complete an incident report regarding a medication error. Which of the following actions should the nurse plan to take? (Select all that apply.)

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?

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