1. A pt presses the call bell and requests pain medication for a severe
headache. To assess the quality of the pt. Pain, which approach should
the nurse use?: Ask the patient to describe the pain
2. The nurse is wearing personal protective equipment while caring for a
pt. When exiting the room, which PPE should be removed first?: Gloves
3. An older pt is brought to the ED with a sudden onset of confusion that
occurred after experiencing a fall at home. The daughter, who has power of
attorney, has brought the client's prescriptions. Which information should
the nurse provide first when reporting to the healthcare provider using
SBAR communication?: Increasing confusion of the pt.
4. A pt tells the nurse about working out with a personal trainer and
swimming three times a week in an effort to lose weight and sleep better.
,The pt states that it still is taking hours to fall asleep at night. Which action
should the nurse implement?: Ask the pt for a description of the exercise
schedule that is being followed
5. 2 days prior to discharge from the rehab facility, the nurse is teaching a
pt who is recovering from Guillain-Barre syndrome about home. Which
actions should the nurse include when providing discharge teaching to the
pt and spouse? SATA: -review safe transfer strategies
-develop a nutritional plan
-help identify community support
6. The nurse implements a tertiary prevention program for type 2 diabetes
in a rural health clinic. Which outcome indicates that the program was
effective?-
: pt who develop disease complications promptly received rehabilitation
7. The nurse has received funding to design a health promotion project for
African American women who are at risk for developing breast cancer.
, Which resource is most important in designing this program?: participation
of com- munity leaders in planning the program
8. A pt with multiple injuries is being treated in the burn trauma unit just
hours after the injuries occurred. The healthcare provider instructs the nurse
to avoid auto contamination when performing dressing changes. Which
intervention is most important for the nurse to implement?: use gown,
mask, and gloves with dressing changes
9. A pt is recovering in the critical care unit following a cardiac cath. IV nitro
and heparin are infusing. The pt is sedated but responds to instructions.
After changing positions, the pt complains of pain at the right groin
insertion site. What action should the nurse implement?: Stimulate the pt
to take deep breaths
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