bend over from the waist to pick up objects hold weight as close to the body as possible when carrying something heavy when pulling a client up in bed, position the bed as low as possible to the floor try to lift clients with only one nurse to assist to avoid taking too many nurses…
The nurse is caring for a client with Guillain-Barre syndrome. Due to paralysis, the client is unable to press the call button with his finger. The nurse must make accommodations for this client to be able to call for help. Which action by the nurse is correct?
leave the client’s door open and instruct him to yell loudly for help ask a family member to stay around the clock so she can call for the client round on the client as often as possible since there are no alternatives utilize a call light adapter that will allow the client to call for…
The nurse is preparing to administer metoprolol (Lopressor) to a new client. Which of the following actions by the nurse are correct?
hold for a heart rate greater than 80 bpm check the client’s blood pressure and apical pulse check the client’s allergies before giving any medications verify the client’s identity using two patient identifiers tell the client not to take the medication with grapefruit juice
The nurse is supervising the unlicensed assistive personnel (UAP) while providing care for a client with an internal radioactive implant. Which action by the UAP requires immediate intervention by the nurse?
The UAP assists the client in setting up the meal tray. The UAP wears a dosimeter badge while performing client care. The UAP closes the door to the room upon entering and exiting. The UAP places soiled linen in a laundry cart and takes it to the soiled utility area.
The nurse is caring for a client with an internal cervical radiation implant. When performing morning care, the nurse notes the implant lying on the bed. Which nursing action should be done first ?
notify the health care provider apply gloves and attempt to reinsert the implant retrieve the implant with long-handled forceps and place into a lead container don a lead apron and retrieve the implant with long-handled forceps and place into a lead container
The nurse is caring for a client who just returned from a supratentorial craniotomy, during which a large tumor was removed. Which of the following interventions by the nurse are appropriate for this client?
elevate the head of the bed 30 degrees elevate the head of the bed 90 degrees monitor neurological status every 2 hours monitor for signs of increased intracranial pressure apply antiembolism stockings to the client once he is alert turn the client every 2 hours from the operative side to the nonoperative side
The nurse is caring for a client with a left pneumothorax and a water-seal chest tube. Which of the following indicates a need for further action by the nurse?
The client is resting in a semi-Fowler’s position. The client is resting in a Trendelenburg’s position. The suction control chamber has constant gentle bubbling. Constant bubbling is present in the water seal after clamping off suction. Tidaling is present in the water seal chamber and corresponds to respiration.
The nurse has given a client an injection and then notes that the sharps container is full. Which is the correct action by the nurse?
exchange the full container for a new one place the syringe on top of the container so it will not roll off force the syringe into the top of the container as well as it will fit put the syringe into her pocket and dispose of it in another room
The nurse is preparing to perform suctioning on a client with a tracheostomy who is not on a mechanical ventilator. Which of the following actions by the nurse are appropriate?
The nurse instills normal saline into the airway before suctioning. The nurse applies intermittent suction for 15 seconds while pulling the catheter straight out. The nurse hyperoxygenates the client with the manual resuscitation bag before suctioning. The nurse quickly inserts the catheter during inspiration until resistance is met or the client coughs. The nurse quickly…
The nurse is caring for a client who is paralyzed on the left side due to a stroke. The unlicensed assistive personnel (UAP) is assisting the nurse with a bed bath. Which action by the UAP requires intervention by the nurse?
The UAP places dirty linen on the floor during the bed change. The UAP first washes his hands and dons gloves before beginning the bath. The UAP drapes the client for privacy and warmth during the course of the bath. The UAP asks the client if she needs to use the bedpan before beginning the…