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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A Reason: This is the best action because it prevents the spread of infection to other clients and staff. Mumps is a viral infection that causes inflammation of the salivary glands and can be transmitted by respiratory droplets. The nurse should place an isolation cart outside of the room and wear a mask, gloves, and gown when entering.

Choice B Reason: This is not the first priority because it does not address the risk of infection. The nurse should schedule bedside play time with the occupational therapist to promote the child's development and coping, but this can be done later.

Choice C Reason: This is not the first priority because it does not ensure that infection control measures are in place. The nurse should instruct the child's parents about the need for transmission precautions and educate them on how to care for their child at home, but this can be done later.

Choice D Reason: This is not the first priority because it does not prevent the spread of infection. The nurse should assign the child to a room close to the nurse's station to monitor his condition and provide comfort, but this is not a critical intervention.

A. Nurse case manager. B. Adult nurse practitioner. C. Neurology unit supervisor. D. Risk management nurse.

Correct Answer is A

Explanation

Choice A Reason: This role is responsible for coordinating the continuum of care for clients with complex health needs, such as head injury. The nurse case manager collaborates with the interdisciplinary team, the client, and the family to plan, implement, and evaluate the client's care from admission to discharge.

Choice B Reason: This role is responsible for providing primary and specialty care to adults, such as diagnosing and treating acute and chronic conditions, prescribing medications, and ordering tests. The adult nurse practitioner may be involved in the client's care, but not in coordinating it.

Choice C Reason: This role is responsible for managing the daily operations of the neurology unit, such as staffing, budgeting, quality improvement, and staff development. The neurology unit supervisor may oversee the client's care while on the unit, but not throughout the continuum of care.

Choice D Reason: This role is responsible for identifying and preventing potential risks and liabilities in the healthcare setting, such as errors, injuries, infections, or lawsuits. The risk management nurse may monitor the client's care for quality and safety issues, but not for coordination.

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It is most important to assign which client to a registered nurse rather than a practical nurse (PN)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 5-year-old boy with mumps is being transferred to the pediatric unit. Which nursing intervention is most important for the nurse to implement?

Correct Answer is A

Explanation

An adult client is admitted via the Emergency Department with a head injury that will initially require intensive care. Which role is responsible for coordinating the progression of this client's care through rehabilitation and discharge?

Correct Answer is A

Explanation

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Four clients are scheduled to receive IV infusions, but there are only three intravenous (IV) pumps available. Which prescribed infusion can most safely be administered without an IV infusion pump?

The charge nurse of a critical care unit must transfer a client to a general unit to make a bed available for an incoming trauma client. Based on the information provided, which client is best for the nurse to recommend for transfer to the general unit?

The charge nurse in an emergency center is planning client care assignments for the staff. Which action may be safely delegated to the practical nurse (PN)?

A staff nurse has been tardy for morning shift assignments for the past three days and provides no explanation for arriving late. Which approach is best for the nurse manager to use when addressing this staff member's tardiness?

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