nursing care > EXAM > RN COMPREHENSIVE ONLINE PRACTICE 2019 A WITH NGN (RETAKE) QUESTIONS AND ANSWERS + RATIONALE |GUARANT (All)
A nurse is caring for a client who has hypertension and is taking captopril. Which of the following tasks should the nurse delegate to assistive personnel (AP)? Obtain the client's blood pressure ... before the nurse administers medication. The nurse can delegate obtaining blood pressure before and after medication administration because this task is within the range of function for an AP. Initiate a referral with a dietitian for the client. Initiating a referral with a dietitian requires assessment skills and is the role of the nurse. Inform the client about the adverse effects of the medication. Informing the client about the adverse effects of a medication is the role of the nurse. Recommend a salt substitute to the client. Recommending a salt substitute to the client is the role of the nurse and is outside the range of function for an AP. A charge nurse assigns a newly licensed nurse to care for a client who has a chest tube. The nurse expresses concern about having limited experience with monitoring chest tube drainage. Which of the following actions should the charge nurse take first to provide teaching about chest tubes? Refer the nurse to the procedure manual. The charge nurse should instruct the newly licensed nurse to consult the procedure manual for further information. Use a diagram to explain the procedure to the nurse. The charge nurse should use a diagram to explain the procedure and enhance the nurse's understanding. Demonstrate the procedure to the nurse. The charge nurse should use a demonstration to model the procedure to the newly licensed nurse. Ask the nurse about their knowledge of the procedure. The first action the charge nurse should take using the nursing process is to assess the newly licensed nurse's knowledge about the procedure. By assessing the nurse's knowledge, the charge nurse can identify the nurse's learning needs. A home health nurse is assessing a 2-week-old newborn who had a birth weight of 3.64 kg (8 lb) and is being breastfed. Which of the following findings indicates effective breastfeeding? The newborn nurses every 4 hr during the day and sleeps through the night. Measuring duration and frequency of nursing is not an effective way to evaluate the effectiveness of breastfeeding. The newborn has six to eight wet diapers per day. Measuring the number of wet diapers per day is an effective measurement of adequate intake. Six to eight wet diapers each day after the fourth day of life indicates effective breastfeeding. The newborn's current weight is 3.18 kg (7 lb). A newborn is expected to gain 20 to 28 g (0.04 to 0.06 lb) per day after the fourth or fifth day and surpass the birth weight in 10 to 14 days. Slow weight gain can be an indication of ineffective breastfeeding. The newborn has sticky, greenish stools. The breastfed newborn's stool should be yellow, soft, and seedy by the end of the first week of life. Newborns who continue to have meconium in their stools after the first week of life should be evaluated for ineffective breastfeeding. [Show More]
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