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While instructing a male client's wife in the performance of passive range-of-motion exercises to his contracted shoulder, the nurse observes that she is holding his arm above and below the elbow. What nursing action should the nurse implement? A. Acknowledge that she is supporting the arm correctly. B. Encourage her to keep the joint covered to maintain warmth. C. Reinforce the need to grip directly under the joint for better support. D. Instruct her to grip directly over the joint for bet...

1) A client who is in hospice care complains of increasing amounts of pain. The healthcare provider prescribes an analgesic every four hours as needed. Which action should the LPN/LVN implement? A. Give an around-the-clock schedule for administration of analgesics. B. Administer analgesic medication as needed when the pain is severe. C. Provide medication to keep the client sedated and unaware of stimuli. D. Offer a medication-free period so that the client can do daily activities. Correc...

3. A nurse reviews an immobilized patient’s laboratory results and discovers hypercalcemia. Which condition will the nurse monitor for most closely in this patient? 1 a. Hypostatic pneumonia b. Renal calculi c. Pressure ulcers d. Thrombus formation ANS: B Renal calculi are calcium stones that lodge in the renal pelvis or pass through the ureters. Immobilized patients are at risk for calculi because they frequently have hypercalcemia. Hypercalcemia does not lead to hyposta...

A client who is admitted with emphysema is having difficulty breathing. In which position should the nurse place the client? A.High Fowler's position without a pillow behind the head B.Semi-Fowler's position with a single pillow behind the head C.Right side-lying position with the head of the bed elevated 45 degrees D.Sitting upright and forward with both arms supported on an over the bed table D Adequate lung expansion is dependent on deep breaths that allow the respiratory muscles to in...

39. Which nursing action for a patient with chronic obstructive pulmonary disease (COPD) could the nurse delegate to experienced unlicensed assistive personnel (UAP)? a. Obtain O2 saturation using pulse oximetry. b. Monitor for increased O2 need with exercise. c. Teach the patient about safe use of O2 at home. d. Adjust O2 to keep saturation in prescribed parameters. ANS: A UAP can obtain O2 saturation (after being trained and evaluated in the skill). The other actions require more educ...

A nurse teaches the patient about the gate control theory. Which statementmade by a patient reflects a correct understanding about the relationship between the gate control theory of pain and the use of meditation to relievepain? “Meditation controls pain by blocking pain impulses from coming a. through the gate.” “Meditation alters the chemical composition of pain neuroregulators, b. which closes the gate.” “Meditation will help me sleep through the pain because it opens the ...

1. At 34- weeks gestation, a primigravida is assessed at her bimonthly clinic visist,. Which assessment 2. finding is important for the nurse to report to the hcp? D. Weight gain of 7 pounds 3. A newborn infant is receiving immunization prior to discharge. Which action should the nurse implement? D. Obtain signed consent from the mother for administration of hepatitis B vaccine 4. A multiparous woman at 38-weeks gestation with a history of rapid progression of labor is admitted for ind...

2. When assessing patient with nutritional needs, which patients will require follow-up from the nurse? (Select all that apply.) a. A patient with infection taking tetracycline with milk b. A patient with irritable bowel syndrome increasing fiber c. A patient with diverticulitis following a high-fiber diet daily d. A patient with an enteral feeding and 500 mL of gastric residual A patient with dysphagia being referred to a speech-language e. pathologist ANS: A, C, D The nurse sho...

1. A parish nurse is visiting an older adult client who was recently widowed. The client tells the nurse that he no longer has a way to get to the grocery store or the doctor. Which of the following responses by the nurse is appropriate “How would you feel about me contacting a local service that helps older adults with transportation?” 2. A case manager nurse is caring for a client being discharged post total hip arthroplasty. Which of the following activities is an example of the nurse f...

An oriented patient has recently had surgery. Which action is best for the nurse to take to assess this patient’s pain? a. Assess the patient’s body language. b. Ask the patient to rate the level of pain. c. Observe the cardiac monitor for increased heart rate. d. Have the patient describe the effect of pain on the ability to cope. ANS: B One of the most subjective and therefore most useful characteristics for reporting pain is its severity. Therefore, the best way to assess a ...