(answered)PN Live Review Management 2020 Rationales included.

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PN Live Review Management 2020 A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about safe home disposal of insulin syringes and needles. Which of the following statem... ents by the client indicates an understanding of the teaching? A) "I'll recap the needles and discard them in their original wrappers in a metal trash can." B) "I'll collect the needles in a rigid plastic laundry detergent container and take them to a hazardous waste facility." C) "I'll put the needles in a sealed red bag and bring them to the hospital for disposal." D) "I'll collect the needles in a disposable aluminum pie plate and fold it in half before I put it in the trash." - "I'll collect the needles in a rigid plastic laundry detergent container and take them to a hazardous waste facility." Rationale: The client should use an impervious container made of heavy plastic, such as a laundry detergent container, to prevent self-injury. The client can take the container to a community drop-off program or a hazardous waste facility for disposal. ------------------- "I'll recap the needles and discard them in their original wrappers in a metal trash can." The client risks injury to themself and others by recapping the needles and discarding them in a trash can. -------------------------- "I'll put the needles in a sealed red bag and bring them to the hospital for disposal." Used needles can puncture a plastic bag and cause injury to the client and others. A hospital does not provide disposal services for clients. ---------------------------- "I'll collect the needles in a disposable aluminum pie plate and fold it in half before I put it in the trash." A folded pie plate could allow needles and syringes to slip out and cause injury to the client and others. Furthermore, discarded needles cannot be placed in the trash. They must be taken to a hazardous waste facility and incinerated. A nurse is contributing to a plan of care for a client and recognizes that one of the established goals is unrealistic. Which of the following actions should the nurse take? A) Document the client's noncompliance with the plan of care. B) Recommend a revision to the plan of care. C) Discontinue nursing interventions related to the goal. D) Create a new plan of care. - B) Recommend a revision to the plan of care. Rationale: The nurse should recommend a revision to the plan of care to reflect the client's current state of health and abilities to adhere to the plan. ------------------------ Document the client's noncompliance with the plan of care. The nurse should provide objective documentation of the client's current state of health and abilities to comply with the plan. ------------- Discontinue nursing interventions related to the goal. The nurse should not discontinue nursing interventions related to the goal. The nurse should assist the RN to revise the interventions to meet the goal of the plan of care. ---------------------------- Create a new plan of care. It is beyond the scope of practice for the PN to create a new plan of care. The nurse should assist the RN in revising the client's plan of care. A nurse observes two assistive personnel (AP) at a client's bedside disagreeing about the way to bathe a client. Which of the following actions should the nurse take? A) Ask the client if they want a bath. B) Tell the AP to proceed with the client's bath. C) Ask the AP to speak to the nurse outside the client's room. D) Request assistance from a security officer. - C) Ask the AP to speak to the nurse outside the client's room. Rationale: The nurse should remove the AP from the client's room and use active listening to resolve the conflict. ---------------------------- Ask the client if they want a bath. It is not appropriate to ask the client if they want a bath while the staff is having a conflict. The conflict should be resolved without involving the client. ------------- Tell the AP to proceed with the client's bath. Instructing the AP to proceed with the client's bath is not in the best interest of the client. The conflict must be addressed, and without resolution, the conflict might have a negative impact on the client. ------------------------- Request assistance from a security officer. There is no indication that a security officer needs to be involved in the conflict. A nurse is assisting with the admission of a client to a medical-surgical unit. Which of the following statements should the nurse make to the client? A) "We will keep your vital signs on a message board in your room." B) "You need to give written permission for your medical information to be released." C) "We must let you know each time new health care personnel looks at your chart." D) "You can sign a general consent now that will cover all hospital procedures." - B) "You need to give written permission for your medical information to be released." Rationale: Under HIPAA privacy laws, client consent is required to release medical information. The nurse should reinforce with the client that the requirement is in place to protect the client's information. Only those directly involved in client care have a right to access the information. ------------------------------ "We will keep your vital signs on a message board in your room." The nurse should not include a client's personal health information on a message board in the client's room. This is a violation of confidentiality. -------------------------------- "We must let you know each time new health care personnel looks at your chart." HIPAA laws allow information to be shared with health care personnel directly involved in client care. This can include providers, nurses, and therapists from various disciplines. It is not a requirement to notify the client each time the medical record is reviewed. -------------- "You can sign a general consent now that will cover all hospital procedures." A general consent form is signed on admission to a facility and covers most routine procedures. A separate consent must be obtained before certain procedures or invasive diagnostic tests are performed. A nurse is contributing to a discussion about informed consent during a staff meeting. Which of the following clients should the nurse identify as requiring a guardian to provide consent for general treatment? A) A young adult client who has schizophrenia B) A 17-year-old client who dropped out of high school C) A 16-year-old client who has a newborn D) An older adult client who has brain cancer - B) A 17-year-old client who dropped out of high school Rationale: Minors are required to have a parent or guardian provide consent for general medical care. Some states allow minors to give consent for certain treatments, such as for a mental illness or sexually transmitted infection. An emancipated minor can give consent. ------------------------ A young adult client who has schizophrenia Mental illness does not make an individual incapable of providing consent. If the client's mental capacity becomes questionable, health care personnel should determine whether the client is still competent. A court ruling might be required to declare incompetence. ---------------------- A 16-year-old client who has a newborn A minor who has a child is considered emancipated and can provide consent. Minors also are able to provide consent for children of whom they are guardians or have custody. In some states a client who is pregnant might be considered emancipated. ----------------------- An older adult client who has brain cancer An older adult client who has brain cancer can provide legal consent for care and treatment. The nurse should encourage all clients to complete advance directives, especially in situations where the client's diagnosis could affect judgment in the future. A nurse is assisting with planning care for a client who has had a stroke. The nurse should initiate a referral to an occupational therapist for which of the following tasks? A) Assisting with ambulatory devices B) Introducing a bladder training program C) Incorporating RDAs D) Completing ADLs - D) Completing ADLs Rationale: An occupational therapist assists the client to develop fine motor skills and coordination, such as improving hand strength and hand movements. The occupational therapist focuses on self-management of ADLs, such as skills needed for eating, hygiene, and dressing. ---------------------- Assisting with ambulatory devices A physical therapist assists a client with mobility skills, including the use of ambulatory devices such as a walker or a cane. ----------------------- Introducing a bladder training program The nurse should assist the client with bowel and bladder training. This training can include a regular toileting schedule and applying light pressure to the bladder to facilitate urination, which is known as Crede's maneuver. ------------------------- Incorporating RDAs A dietitian should help the client meet recommended dietary allowances (RDAs). The dietitian also can assess the client for dysphagia and develop meal plans based on the client's needs. A nurse is contributing to the plan of care to meet the nutritional needs of a client who has dysphagia. To which of the following interdisciplinary team members should the nurse refer the client? A) Physical therapist B) Social worker C) Speech pathologist D) Respiratory therapist - C) Speech pathologist ********************************************CONTINUED*********************************************** [Show More]

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