It is most important to assign which client to a registered nurse rather than a practical nurse (PN)?
One hour after receiving hydromorphone prescribed for every 4 hours PRN use, a client reports severe pain.
Two hours after receiving morphine for acute pain, a client's vital signs are BP 112/60 mm Hg, pulse 88 beats/minute, and respirations 14 breaths/minute.
After ambulating, a postoperative client grimaces and reports incisional pain at a "9 on a ten-point scale".
The fentanyl transdermal patch for a client with chronic cancer pain needs to be replaced.
The Correct Answer is C
Choice A Reason: This client may need another dose of hydromorphone if the pain is not relieved by the previous one. A PN can administer this medication under the supervision of a RN and monitor the client's response.
Choice B Reason: This client's vital signs are within normal limits and indicate that the morphine is effective and not causing respiratory depression. A PN can assess and document the client's vital signs and pain level.
Choice C Reason: This is the correct answer because this client has acute and severe pain that may require immediate intervention and reassessment. An RN can evaluate the cause and severity of the pain, administer additional analgesics as prescribed, and implement nonpharmacological measures to relieve the pain.
Choice D Reason: This client has chronic and stable pain that is managed by a fentanyl patch. A PN can replace the patch according to the schedule and instructions provided by the RN.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason: Announcing the new plan at a special employee wellness event may be a good way to promote the plan and celebrate the achievement, but it is not the most important action. The nurses working on the committee should first communicate the plan to their colleagues and address any questions or concerns they may have.
Choice B Reason: Determining staff opinion of current healthcare insurance costs may be useful for evaluating the need and feasibility of the new plan, but it is not the most important action. The nurses working on the committee should have done this before developing and approving the new plan, not after.
Choice C Reason: Surveying the nurses to see who wants to keep the old benefits plan may be helpful for assessing the satisfaction and acceptance of the new plan, but it is not the most important action. The nurses working on the committee should have considered the preferences and needs of their colleagues during the development and approval of the new plan, not after.
Choice D Reason: Being available to all shifts to discuss the changes in health benefits is the most important action for the nurses working on the committee to implement, as it shows respect and transparency for their colleagues, and fosters a collaborative and supportive work environment. The nurses working on the committee should explain the rationale and benefits of the new plan, and provide feedback and guidance to their colleagues.
Correct Answer is D
Explanation
Choice A Reason: This is not the first priority because it does not address the client's immediate needs. The nurse should obtain the client's legal records for power of attorney, but this can be done later.
Choice B Reason: This is a good action because it helps relieve the client's pain and discomfort. The nurse should give analgesic medications as needed (PRN), but this is not enough to meet the client's holistic needs.
Choice C Reason: This is not an appropriate action because it may cause harm to the client. The nurse should not discontinue the intravenous infusion without a valid reason and a healthcare provider's order.
Choice D Reason: This is the best action because it respects the client's wishes and provides him with quality end-of-life care. The nurse should ask the palliative care team to speak with the client and offer him emotional, spiritual, and physical support.
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