A nurse is reviewing the guidelines for documenting client care.
Which of the following actions should the nurse plan to take?

Avoid quoting client comments when documenting.

Document giving a dose of pain medication just prior to administration.

Document information telephoned in by a nurse who left the unit for the day.

Limit documentation to subjective information.

Answer and Explanation

The Correct Answer is C

The correct answer is Choice C.

Choice A rationale: Quoting client comments when documenting provides accurate and direct information. It ensures the client's exact words are recorded, which is important for clear communication among healthcare providers and for legal documentation.

Choice B rationale: Documenting medication administration should occur immediately after giving the dose, not prior. This ensures accuracy and prevents potential errors or omissions, maintaining the integrity and safety of the client's medical record.

Choice C rationale: Documenting information telephoned in by a nurse who left the unit ensures continuity of care. It accurately records details that may be critical to the client's treatment and care plan, ensuring that all healthcare providers have up-to-date information.

Choice D rationale: Limiting documentation to subjective information is not sufficient. Comprehensive documentation should include both subjective (client's statements) and objective (measurable data) information to provide a complete and accurate picture of the client's condition and care.

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Correct Answer is B

Explanation

Choice A rationale:

Hospice care is typically recommended for clients with a terminal illness who are no longer seeking curative treatment. It may not be suitable for an older adult with early onset dementia unless their condition is very advanced.

Choice B rationale:

Recommending an adult day care facility is appropriate in this situation. Adult day care centers provide a safe and stimulating environment for older adults who require supervision and socialization during the day. It can be a helpful resource for the client's care while the adult child is at work.

Choice C rationale:

Suggesting a community senior center is a good option for social engagement and activities, but it may not provide the level of supervision and care needed for an older adult with dementia, especially if the adult child works full-time.

Choice D rationale:

Recommending a long-term care facility is a more drastic step and is typically considered when a client's care needs cannot be met at home or in less restrictive settings. It may not be necessary for a client with early onset dementia who still has family support.

A. Nausea. B. Hand tremors. C. Swelling of the lips. D. Hyperglycemia.

Correct Answer is C

Explanation

Choice A rationale:

Epinephrine is not typically used to treat nausea. Nausea is usually managed with antiemetic medications.

Choice B rationale:

Epinephrine is not used to treat hand tremors. Hand tremors may be related to various conditions, and their management would depend on the underlying cause.

Choice C rationale:

The correct manifestation that epinephrine can help treat is "Swelling of the lips." Epinephrine is commonly used to treat severe allergic reactions (anaphylaxis), which can cause swelling of the lips, tongue, and throat. Epinephrine helps to reverse these symptoms by constricting blood vessels and opening the airways.

Choice D rationale:

Epinephrine is not used to treat hyperglycemia. Hyperglycemia is managed with insulin or other antidiabetic medications, not epinephrine.

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A nurse is reviewing the guidelines for documenting client care. Which of the following actions should the nurse plan to take?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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A nurse is reviewing the guidelines for documenting client care.
Which of the following actions should the nurse plan to take?