A nurse in a pediatric unit is preparing to insert an IV catheter for 7-year-old. Which of the following actions should the nurse take? - answerB. Tell the child they will feel discomfort during the catheter insertion. A nurse is caring for a client who has arteriovenous fistula Which of the following findings should the nurse report? - answerB. Absence of a bruit. A nurse is providing discharge teaching for a client who has an implantable cardioverter defibrillator which of the following statements demonstrates understanding of the teaching? - answerB. "I will wear loose clothing around my ICD" A nurse is caring for a client who is at 14 weeks gestation and reports feelings of ambivalence about being pregnant. Which of the following responses should the nurse make? - answer"Describe your feelings to me about being pregnant" A nurse is planning care for a client who has a prescription for a bowel- training program following a spinal cord injury. Which of the following actions should the nurse include in the plan of care? - answerAdminister a rectal suppository 30 minutes prior to scheduled defecation times. A nurse is caring for a client who is in active labor and requests pain management. Which of the following actions should the nurse take? - answerB. Place the client in a warm shower A nurse in an emergency department is performing triage for multiple clients following a disaster in the community. To which of the following types of injuries should the nurse assign the highest priority? - answerBelow the knee amputation A nurse manager is updating protocols for the use of belt restraints. Which of the following guidelines should the nurse include? - answerDocument the client's condition every 15 mins. A nurse is teaching an in-service about nursing leadership. Which of the following information should the nurse include about an effective leader? - answerA. Acts as an advocate for the nursing unit. A nurse is reviewing the laboratory findings of a client who has diabetes mellitus and reports that she has been following her (unable to read) care. The nurse should identify which of the following findings indicates aa need to revise the client's plan of care - answerC. Hba1c 10 % A nurse in a provider's office is reviewing the lab results of a group of clients. the nurse should identify that which of the following sexually transsmitted infections is a nationally notifiable infectious disease that should be reported to the state health department? - answerChlamydia A nurse is teaching a newly licensed nurse about therapeutic techniques to use when leading a group on a mental health unit. Which technique should the nurse use in the teaching? - answerUse modeling to help the clients improve their interpersonal skills A nurse is planning for a client who practices Orthodox Judaism. The client tells the nurse that (Unable to read) Passover holiday. Which of the following action should the nurse include in the plan of care? - answerC. Provide unleavened bread. A nurse is caring for a client who has a pulmonary embolism. The nurse should identify the effectiveness of the treatment - answerB. The client reports feeling less anxious. A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets (Unable to read) a respiratory rate of 10/min. After securing the client's airway and initiating an IV, which of the following actions should the nurse do next. - answerB. Administer flumazenil to the client A nurse in an emergency department is caring for a client who reports cocaine use 1 hour ago. Which of the following findings should the nurse expect? - answerElevated Temperature A nurse is assessing a newborn who has a blood glucose level of 30 mg/dl. Which of the following manifestations should the nurse expect? - answerJitteriness A nurse in a pediatric clinic is reviewing the laboratory test results of a school age child. Which of the following findings should the nurse report to the provider? - answerD. WBC 14,000/mm3 A charge nurse is teaching a newly licensed nurse about clients designating a health care proxy in situations that require a durable power of attorney for health care (DPAHC). Which of the following information should the charge nurse include? - answerThe proxy can make treatment decisions if the client is under anesthesia. A nurse in the PACU is caring for a client who reports nausea. Which of the following actions should the nurse take first? - answerA. Turn the client on their side. A nurse is caring for a client who has a history of depression and is experiencing a situational crisis. Which of the following actions should the nurse take first? - answerConfirm the client's perception of the event A nurse is caring for a client who has bipolar disorder and is experiencing acute mania. The nurse obtained a verbal prescription for restraints. Which of the following should the actions should the nurse take? - answerD. Document the client's condition every 15 minutes. A nurse working on a surgical unit is developing a care plan for a client who has paraplegia. The client has an area of nonblanchable erytherma over his ischium. Which of the following interventions should the nurse include in the care plan? - answerPlace the client upright on a donut shaped cushion. A charge nurse on a medical-surgical unit is planning assignments for a licensed practical nurse (LPN) who has been sent from the (Unable to read) unit due to a staffing shortage. Which of the following client should the nurse delegate to the LPN? - answerC. A client who is postoperative following a bowel resection with an NG tube set to continuous suction.