The nurse evaluates a client's plan of care. The client has an outcome of 'Client will learn self-glucose testing before discharge'. When evidence best allows the nurse to meet the outcome of the plan?

Client demonstrates correct glucose testing.

Client says 'I can do the testing now'.

Client explains the testing process to the nurse.

Client observes the nurse test glucose 5 times.

Answer and Explanation

The Correct Answer is A

This is because the outcome of the plan is for the client to learn self-glucose testing, which implies that the client can perform the testing correctly on their own. Option A shows that the client has successfully learned and can perform the skill independently, which is the ultimate goal of the plan.

Option B, "Client says 'I can do the testing now'," and option C, "Client explains the testing process to the nurse," may show that the client has some understanding of the testing process, but they do not demonstrate that the client can perform the skill independently.

Option D, "Client observes the nurse test glucose 5 times," is not an appropriate method for evaluating the client's ability to perform self-glucose testing. Observing the nurse perform the skill does not demonstrate that the client has learned the skill themselves.

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Correct Answer is D

Explanation

It is important to use the appropriate suction pressure, time, and catheter size when suctioning a tracheostomy to prevent injury and ensure eﬀective removal of secretions.

A. Presence of exudate B. A number of sutures C. Approximation of edges D. Time of last antibiotic E. Color of the wound bed

Correct Answer is ["A","C","E"]

Explanation

a. Presence of exudate: The presence and amount of exudate can indicate the severity of the infection and the eﬀectiveness of treatment.

c. Approximation of edges: This refers to how well the edges of the wound are coming together and healing, which is important in evaluating the progress of healing.

e. Color of wound bed: The color of the wound bed can also indicate the severity of infection and the eﬀectiveness of treatment.

Therefore, the correct answers are a, c, and e.

The number of sutures and the time of the last antibiotic are important information for the nurse to know, but they do not need to be included in the documentation of the wound assessment and dressing change.

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The nurse evaluates a client's plan of care. The client has an outcome of 'Client will learn self-glucose testing before discharge'. When evidence best allows the nurse to meet the outcome of the plan?

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Naxlex Comprehensive Predictor Exams

An infant client has a tracheostomy. The nurse prepares to suction the tracheostomy. Which most important principle does the nurse use to plan care?

Correct Answer is D

Explanation

The nurse provides care for a patient with an infected surgical wound. The nurse assesses the wound and changes the dressing. Which does the nurse include in the documentation? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

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