The practical nurse (PN) observes an unlicensed assistive personnel (UAP) bathing a bedfast client with the bed in the high fowlers position. Which action should the PN take?

Assume care of the client immediately.

Remain in the room to supervise the UAP.

Instruct the UAP to lower the bed for safety.

Determine if the UAP would like assistance.

Answer and Explanation

The Correct Answer is C

The correct answer is choice C: Instruct the UAP to lower the bed for safety.

Choice C rationale: When bathing a bedfast client, the bed should be in a flat or low position to reduce the risk of the client sliding down, falling, or experiencing discomfort or injury. By instructing the UAP to lower the bed, the PN ensures client safety during the bathing process.

Choice A rationale: Assuming care of the client immediately might be unnecessary. The PN should first address the safety concern and then determine if additional intervention is needed.

Choice B rationale: While supervising the UAP may be appropriate in certain situations, the priority in this case is to address the immediate safety concern by instructing the UAP to lower the bed. The PN can then decide if supervision or assistance is required.

Choice D rationale: Determining if the UAP would like assistance is considerate, but it is not the priority in this situation. Ensuring client safety by lowering the bed should be addressed first. The PN can then assess whether the UAP needs any help or guidance.

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Correct Answer is B

Explanation

Choice A rationale:

Obtaining a urine specimen for analysis is an important step in the assessment of the client with renal calculi. However, it is not the most immediate intervention when the client is experiencing severe flank pain and hematuria. Pain management should take precedence.

Choice B rationale:

This is the correct answer. Severe flank pain in a client with renal calculi is indicative of renal colic, which is typically excruciating. Administering a prescribed opioid analgesic is the priority to relieve the client's pain and distress.

Choice C rationale:

Straining the urine for the presence of stones is an essential nursing intervention to identify and collect any passed stones. However, it is not the most immediate action when the client is in severe pain. Pain management is the priority.

Choice D rationale:

Preparing the client for a prescribed computed tomography (CT) scan is an important diagnostic step to assess the location and size of the renal calculi. However, it is not the most immediate intervention when the client is in severe pain and distress. Pain management should come first.

A. Elevated serum creatinine level. B. Elevated serum alanine aminotransferase level. C. Elevated serum potassium level. D. Elevated white blood cell count. E. Elevated platelet count.

Correct Answer is ["A","B","D"]

Explanation

Choice A rationale:

An elevated serum creatinine level can indicate kidney dysfunction or damage, which can be a possible adverse effect of amoxicillin-clavulanate. The kidneys are responsible for excreting the medication, and elevated creatinine levels suggest impaired renal function.

Choice B rationale:

An elevated serum alanine aminotransferase (ALT) level is indicative of liver dysfunction or damage. Amoxicillin-clavulanate can sometimes cause hepatotoxicity as a side effect, and elevated ALT levels may suggest this adverse effect.

Choice D rationale:

An elevated white blood cell count (leukocytosis) can be a possible adverse effect of amoxicillin-clavulanate, indicating an increase in the body's immune response. This could be due to an allergic reaction or other adverse reactions to the medication.

Choice C rationale:

An elevated serum potassium level is not typically associated with amoxicillin-clavulanate use. This finding is more likely related to other factors such as kidney dysfunction or certain medications like potassium-sparing diuretics.

Choice E rationale:

An elevated platelet count is not typically associated with amoxicillin-clavulanate use. This finding is more likely related to other factors, such as a bone marrow disorder or inflammation.

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The practical nurse (PN) observes an unlicensed assistive personnel (UAP) bathing a bedfast client with the bed in the high fowlers position. Which action should the PN take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with renal calculi is experiencing hematuria and reports severe flank pain.Which intervention should the nurse implement first?

Correct Answer is B

Explanation

A nurse is reviewing laboratory results for a client who has been taking amoxicillin-clavulanate (Augmentin) for a bacterial respiratory tract infection.Which of the following findings should alert the nurse to a possible adverse effect of this medication? (Select all that apply.).

Correct Answer is ["A","B","D"]

Explanation

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