A nurse on a medical-surgical unit is caring for a client who has hearing loss. Which of the following actions should the nurse take?

Speak in a louder than usual tone of voice during conversation.

Mute the client’s television before beginning a conversation.

Avoid the use of hand gestures when talking to the client.

Use short phrases when talking to the client.

Answer and Explanation

The Correct Answer is D

Use short phrases when talking to the client.

Some possible explanations for the other choices are:

Choice A is wrong because speaking in a louder than usual tone of voice during conversation can distort the sound and make it harder for the client to understand.

The nurse should speak in a normal tone and enunciate clearly.

Choice C is wrong because avoiding the use of hand gestures when talking to the client can limit nonverbal communication and reduce the client’s comprehension.

The nurse should use appropriate facial expressions

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Correct Answer is C

Explanation

A bone scan that is scheduled for today. The nurse should include this information in the change-of-shift report because the oncoming nurse might have to modify the client’s care to accommodate leaving the unit.

Choice A is wrong because the client’s input and output for the shift are routine data that can be found in the client’s chart and do not need to be verbally reported.

Choice B is wrong because the client’s blood pressure from the previous day is not relevant to the current condition of the client and does not reflect any changes or interventions.

Choice D is wrong because the medication routine from the medication administration record is also routine data that can be accessed by the oncoming nurse and does not indicate any special needs or concerns.

A. Muscle irritability. B. Constipation. C. Hypoglycemia. D. Increased BP.

Correct Answer is A

Explanation

Muscle irritability. A client with a lithium level of

2.0 mEq/L has severe lithium toxicity, which can cause muscle irritability, tremors, seizures, and other neurological symptoms. The normal therapeutic range for lithium is 0.8-1.2 mEq/L.

Choice B is wrong because constipation is not a sign of lithium toxicity, but rather a possible side effect of lithium therapy at lower doses.

Choice C is wrong because hypoglycemia is not a sign of lithium toxicity, but rather a possible complication of diabetes or other conditions that affect blood sugar levels.

Choice D is wrong because increased blood pressure is not a sign of lithium toxicity, but rather a possible risk factor for cardiovascular disease or other conditions that affect blood vessels.

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A nurse on a medical-surgical unit is caring for a client who has hearing loss. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to give change-of-shift report to the oncoming nurse. Which of the following information should the nurse include?

Correct Answer is C

Explanation

A nurse is reviewing a client’s laboratory results prior to administering the client’s medications. The nurse notes that the client’s lithium level is 2.0 mEq/L. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

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