A nurse is developing the plan of care for a client who does not speak the same language as the nurse. Which of the following interventions should the nurse include?

Determine the client's level of fluency in his primary language.

Encourage the client to nod to indicate understanding.

Speak directly to the interpreter when teaching the client.

Make sure a family member is present to interpret for the staff.

Answer and Explanation

The Correct Answer is A

This is important because it allows the nurse to assess the client's ability to communicate in their primary language. Knowing the client's level of fluency helps the nurse determine the most effective communication strategies and whether an interpreter is necessary.

B. While nodding can be a form of nonverbal communication indicating understanding, relying solely on this may not accurately gauge the client's comprehension.

C. Even in the presence of n interpreter, the nurse should speak directly to the client.

D. Family members may not be proficient in both languages or may not accurately convey medical information.

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Correct Answer is C

Explanation

Anxiety is a subjective emotional state characterized by feelings of worry, nervousness, or unease. If the client reports feeling anxious, this would be considered subjective because it is based on their own perception of their emotional state.

A. Alert refers to the client's level of consciousness and awareness of their surroundings.

B. Restlessness refers to a feeling of agitation or inability to stay still.

D. Pacing is an observable behavior where the client is walking back and forth in the room.

A. Amphotericin B B. Erythromycin C. Amoxicillin-clavulanate D. Gentamicin

Correct Answer is C

Explanation

Amoxicillin-clavulanate is a combination antibiotic that contains amoxicillin, which belongs to the penicillin class of antibiotics. Because the child is allergic to penicillin, there is a potential cross-reactivity with amoxicillin, which could lead to an allergic reaction.

A, B, and D are not penicillin antibiotics and do not typically cross-react with penicillin allergies.

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A nurse is developing the plan of care for a client who does not speak the same language as the nurse. Which of the following interventions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who reports feeling stress and anxiety. The client appears restless and is pacing in the room. The client is alert and oriented to person, place, and time. Which of the following findings is subjective?

Correct Answer is C

Explanation

A nurse is caring for a child who is allergic to penicillin. The nurse should verify which of the following prescriptions with the provider?

Correct Answer is C

Explanation

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