B. Apply the restraints to allow as little movement as possible
C.Allow room for two fingers to fit between the clients skin and the restraints
d. remove the restraints every 4 hours
- ANSWER>>c
A nurse is admitting a client who has tuberculosis. Which of the following types of transmission precautions should the nurse plan to initiate?
A. Droplet
B. Airbornes
c. protective environment
d. contact
- ANSWER>>b
A nurse in a well-child clinic receives a telephone call from a parent who states that their child accidentally swallowed paint thinner. The child is awake and alert. Which of the following responses should the nurse make?
A. Have your child drink one large glass of water.
B. Hang up and call a poison control center hotline.
C. Bring your child into the clinic later today.
D. Induce vomiting in your child with syrup of ipecac.
- ANSWER>>a
A nurse is documenting a client's medical record. Which of the following entries should the nurse record.
A. Oral temperature slightly elevated at 0800
B. Administered pain medication
C. Incision without redness or drainage
D. Drank adequate amounts of fluid with meals.
- ANSWER>>b
A nurse is providing oral care for a client who is unconscious. Which of the following actions should the nurse take?
A. Place the client in a side-lying position.
B. Brush the clients teeth daily
C. Apply mineral oil to the client's lips
D. Rinse the client's mouth with an alcohol-based mouthwash
- ANSWER>>a
A nurse is collaborating with a risk management team about potential legal issues involving client care. The nurse should identify which of the following situations is an example of negligence?
A. A nurse administers a medication without first identifying the client.
B. An assistive personnel discusses client care in the facility cafeteria with visitors
present.
C. A nurse begins a blood transfusion without obtaining consent.
D. An assistive personnel prevents a client from leaving the facility.
- ANSWER>>c
A nurse is collecting a sputum specimen for culture from a client who has a respiratory infection. Which of the following actions should the nurse take?
A. Wear sterile gloves when collecting the specimen.
B. Offer the client oral hygiene after the collection
C. Collect the specimen in the evening.
D Collect 1 ml of sputum.
- ANSWER>>b
A nurse is assessing an older client. Which of the following findings should the nurse expect?
a. Decreased sense of balanced
b. Increased nighttime sleeping
c. Heightened sense of pain
d. Nighttime urinary incontinence
- ANSWER>>a
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