A nurse is observing an assistive personnel (AP) changing the linens on the bed of a client who is immobile. Which of the following actions by the AP should the nurse identify as an indication of the need to intervene?

Rolls the client to one side of the bed

Reaches over the bed to straighten the fitted sheet

Lowers the side rail on the side of the bed closest to the AP

Raises the bed to waist level

Answer and Explanation

The Correct Answer is B

A. Rolling the client to one side of the bed is an appropriate action to change the linens.
B. Reaching over the bed to straighten the fitted sheet can cause strain and potential injury to the AP's back and should be corrected.
C. Lowering the side rail on the side of the bed closest to the AP is necessary for changing the linens safely.
D. Raising the bed to waist level is an appropriate action to ensure proper body mechanics and prevent injury.

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Correct Answer is A

Explanation

A. A PT of 45 seconds is prolonged and indicates a potential risk of bleeding due to excessive anticoagulation with warfarin. The nurse should notify the provider for further evaluation and adjustment of the warfarin dosage.
B. Platelets within the normal range (150,000-400,000/mm3) are adequate and do not require immediate provider notification.
C. Hematocrit of 44% is within the normal range for adults and does not indicate an urgent need for provider notification.
D. Hemoglobin of 16 g/dL is within the normal range for adults and does not require immediate provider notification.

Correct Answer is ["125"]

Explanation

To calculate the infusion rate for an IV, the total volume to be infused (in this case, 1000 mL) is divided by the total time of infusion (8 hours). So, the calculation would be 1000 mL divided by 8 hours, which equals 125 mL per hour.

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A nurse is observing an assistive personnel (AP) changing the linens on the bed of a client who is immobile. Which of the following actions by the AP should the nurse identify as an indication of the need to intervene?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing laboratory results of a client who has atrial fibrillation and is taking warfarin. For which of the following results should the nurse notify the provider?

Correct Answer is A

Explanation

A nurse is preparing to administer 0.45% sodium chloride (NaCl) 1000 mL IV to infuse over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)

Correct Answer is ["125"]

Explanation

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