Nursing Process
A RN determines that the patients condition has improved and has met expected outcomes. Which step of the nursing process is the nurse exhibiting?
Evaluation
Why do we encourage postop patients to cough and deep breath?
Prevent atelectasis and pneumonia
RN is providing an education session for preschool workers. The RN reminds the employees about the most important ways to prevent the spread of infection. What information does the nurse provide?
Wash their hands between each interaction with children
Risk assessment for pressure injuries
Braden score
RN is assessing body alignment on a client with mobility issues. What is the nurse monitoring? (not one word)
The relationship of one body part to another while in different positions.
RN is providing nursing care to patients after completing a care plan from nursing diagnoses. In which step of the nursing process is this nurse?
Implementation
Postop client is on a PCA. The RN enters the room and client is sleeping but arouses and reports severe pain. What is the RN's next step?
Assess the clients vital signs
What strategy is used by nurses to that will best demonstrate that the client teaching has been effective?
Using the teach back technique
Sudden and uncontrollable episodes of sleep during the day
Narcolepsy
Alveoli
What diagnosis will the RN document in a care plan that is NANDA-I approved?
Sore throat Sleep apnea
Acute Pain Heart Failure
Acute Pain
Cover the wound with a sterile moist dressing
A client reports pain in the abdomen and describes it as being sharp, stabbing sensation. What type of data does the client's description represent?
Subjective data
A client is recovering from a lap appy. What type of healing will the nurse focus the care plan?
Primary intention
A RN is working on an orthopedic rehab unit that requires a lot of lifting and repositioning. Which personal injury will the RN most likely try to prevent?
Back
RN develops strategies and alternatives to attain an expected outcome. Which standard of nursing practice is the RN following?
Planning
Preventing DVT (2/3 answers)
Mobility
SCD
Medications
True or False
When your crutches fit right, most of your body weight will be supported by your armpits
False
Places to monitor for bed sores when repositioning a patient
elbows, heels, coccyx(butttock), back of head, knees, hips, shoulder blades, back of ears
Postop client develops sudden hypoxia and RR is 28 an SpO2 is 90%. What is the FIRST thing the RN should do?
Elevate the head of bed
RN determines that the client's decreased rate of respirations and inability to sleep are related. What step in the nursing process is this?
Formulate hypotheses/prioritize hypotheses
RN caring for a client who is undergoing a surgical procedure. The RN completes an assessment and reviews lab tests, allergies and prepares the patient for surgery. Which Perioperative phase is the RN working?
Preoperative
What is 5:30 AM and PM in military time?
0530AM
1730PM
RN caring for a client who is experiencing a full thickness wound repair. Which type of tissue will the nurse expect to observe when the wound is healing?
Purulent drainage
A RN caring for a client removes the client's oxygen as prescribed. The client is now breathing what percentage of oxygen in the room air?
21%