Question

Please answer these questions

1. A nurse is preparing teaching about crutch safety to a client. Which of the following client actions indicates an understanding of the teaching?

1. The client leans on both crutches to support body weight
2. The client places the crutches 30 cm (12 in) to the front and side of each foot while standing
3. The client keeps her axillae free of pressure
4. The client flexes her elbows 10 degree when supporting weight by using the handgrips

2. A nurse is developing a plan of care for a client who has preeclampsia and is to receive magnesium sulfate via continuous IV infusion. Which of the following actions should the nurse include in the plan?

1. Monitor the FHR via Dippier every 30 min
2. Restrict the client’s total fluid intake to 250 ml/hr
3. Give the client protamine if sign of magnesium sulfate toxic occur
4. Measure the client’s urine output every hour

3. A nurse is developing a plan of care for a client who has schizophrenia and is experiencing auditory hallucinations. Which of the following should the nurse include in the plan?

1. Avoid eye contact with the client
2. Encourage the client to lie down in a quiet room
3. Ask the client directly what he is hearing
4. Refer to the hallucinations as if they are real

4. A nurse is preparing to perform a dressing on a preschooler. Which of the following action should the nurse take to prepare the child for the procedure?

1. Limit teaching sessions about the procedure to 20 min
2. Explain In simple terms how the procedure will affect the child
3. Ask the parents to wait outside the room during the procedure
4. Instruct the child in deep -breathing methods prior to the procedure

5.A nurse is teaching a client who is receiving radiations therapy about skin protection. Which of the following client statements indicates an understanding of teaching?

1. I will apply my favors lotion to the radiation area of skin twice each day
2. I will use my hand instead of a washcloth to wash the radiated area of the skin
3. I will expose the radiated area of skin to the sun for no more than 30 minutes per day
4. I will make sure I have sterile water to wash the radiated area of skin

6. A charge nurse on a medical surgical unit is planning assignments for a licensed practical nurse (LPN) who has been sent from the postpartum unit due to a staffing shortage for the shift. Which of the following client assignments should the nurse delegate to the LPN?

1. A client who is post following a bowel resection with an NG tube set to continuous suction
2. A client who orientation a conversation and has unequal pupils
3. A client who fractured a fetter yesterday and is experiencing shortness of breath
4. A client who has an high of 6.3gdl and a prescription for packed of RBCs

7.  A nurse is caring for a client who has depression and reports taking St.John’s wort along with citalopram. The nurse should monitor the client for which of the following conditions as a result of an interaction between these substances?

1. Acute dystonia
2. Serotonin syndrome
3. Tardive dyskinesia
4. Pseudoparkinsonism

8. . Nurse is caring for an infant who has respiratory syncytial virus. Which of the following interventions should the nurse take?

1. Initiate isolation precaution
2. Suction nares prior to feeding
3. Request a prescription for guardians

9. A nurse realize that the wrong medication has been administered to a client. Which of the following action should the nurse take first?

1. Report the incident to the nurse manager
2. Fill out and ancient report
3. Measure the clients’ vital signs
4. notify the provider

10. A nurse is caring for a client who is in the advanced stage of amyotrophic lateral sclerosis (ALS). Which of the following referrals is the nurse’s priority?

1. Social worker
2. Speech -language pathologist
3. Psychologist
4. Occupational therapist

Answer 1

1) The clients keeps her axillae free of pressure.Instruct the client never rest the axillae on the axillary bars.The elbows should be slightly flexed 20 to 30 degree when the clent is walking.Instruct the client to look foreward and outward when ambulating and to place the crutches 6 to 10 inches diagonally infront of the foot.

2)Monitor the FHR via dipper every 30 minutes.The nurse monitors the fetal heart rate patterns closely and it helps to prevent seizures .It can be continued for 24 to 48 hours postpartum..The other options are not ppropriate.The antidote of magnesium sulphate is calcium gluconate.

3)Avoid eye contact with the client.Schizophrenia is a group of mental disorders characteristic by psychotic features disordered through processes and distrubed interpersonal relationships.In auditory hallucinations the client experiences false perceptions of sound.Never place the client alone because safety is the first priorty and these client may harm self or others.Stay with patient if they are frightened.

4)Explain in simple terms how the procedure will affect the child.Allow the parents to enter the room thus the child can remove tthe fear for a great extent.