A client is discharged to a long term care facility with an indwelling urinary catheter.
Which nursing action should be included in the plan of care to reduce the client's risk for
infection related to the catheter?
A. Secure the drainage bag at bladder level during transport
B. Encourage increased intake of oral fluids
C. Administer a PRN antipyretic if a fever develops
D. Daily flush the catheter with sterile saline - ANSWER B?
A young adult was admitted to psychiatric unit yesterday. The grandparent requests
information about the client's treatment plan. Which action should the nurse take before
responding to the family member's request?
A. Reassure the grandparent by providing a candid response
B. Check with the healthcare provider regarding this release of information
C. Query the client regarding the release of this information to the
D. The signed release of information includes the grandparent - ANSWER B. Consult
with healthcare provider
The nurse enters a clients room to perform a physical assessment and finds the client
crying. What is the best response by the nurse?
A. Gives the client a hug and says "it is okay to cry when you are sad."
B. While touching the client's forearm, asks "would you like to talk about it?"
C. This is a bad time. I can see you are upset. I can come back later.
D. I am sorry to disturb you at a difficult time. This can wait until later. - ANSWER B.
While touching the client's forearm, asks "would you like to talk about it?"
, A male hospice client is diagnosed with bone cancer and reports to the nurse that his
bone is not sufficiently controlled with his current dose of morphine sulfate. The client
also reports a problem with constipation. Other than increasing the client's laxative
dose, what is the nurse's treatment plan?
A. Decrease the dose of morphine
B. Increase the dose of morphine
C. No additional dose of morphine
D. Discontinue morphine and start codeine - ANSWER B. Titrate the dose of morphine
A client is diagnosed with end-stage metastatic cancer and has a living will that states
no extraordinary measures are to be taken as death approaches. The health care
provider has written a "DNR". The client begins taking gasping breaths and the nurse
discovers that the client's oximeter reading is 85%. What does the nurse do?
A. Administer oxygen via the nasal cannula
A. Administer oxygen through nasal cannula
B. Deliver manual ventilation with a bag-valve-mask device
C. Verify whether the client has experienced a change in wishes
D. Instruct the health care provider about the client's status
This is the question. An older woman is seen at the clinic who reports her chief
complaint of vaginal bleeding. The health care provider identifies a vaginal laceration
and the client relates that this likely occurred during unprotected sexual intercourse.
Which topic should the nurse prioritize when developing this client's teaching plan?
A. Alternatives for expressing sexuality
B. Ways to engage in safe sex
C. The need for using vaginal lubricants
D. Intercourse positions that can prevent tears - ANSWER B. Methods used to practice
safe sex
The nurse assesses that a confused client drank eight glasses of water within two hours
and continues to drink large volumes of water. Based on the nurse's concern for water
intoxication, which lab value should the nurse monitor?
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