What is the primary reason why every step of an intervention is planned before the intervention is implemented?
a. It is required by the nursing process procedure.
b. It is the way in which agencies expect to see performance by the nurse.
c. It saves time, and the implementation process goes more smoothly.
d. It allows the nurse to remember what was going to be done.
ANS: C
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When performing an assessment of a patient, the nurse notices the presence of an enlarged right epitrochlear lymph node. What should the nurse do next?
a. Assess the patient's abdomen, and notice any tenderness. b. Carefully assess the cervical lymph nodes, and check for any enlargement. c. Ask additional health history questions regarding any recent ear infections or sore throats. d. Examine the patient's lower arm and hand, and check for the presence of infection or lesions.
Which question would the community health nurse use as a guide to determine a client's participation in a program?
A) "What does the client know about the current problem?" B) "How does the client view the current situation?" C) "Does the client need special seating?" D) "What does the client want to learn?"
The nurse is teaching a class on nutrition to a group of parents of 10- and 11-year-old children. What statement by one of the parents indicates a correct understanding of the teaching?
a. "My child does not need to eat a variety of foods, just his favorite food groups." b. "My child can add salt and sugar to foods to make them taste better." c. "I will serve foods that are low in saturated fat and cholesterol." d. "I will continue to serve red meat three times per week for extra iron."
The certified nursing assistant (CNA) tells the nurse:
"I can help you with your assessment." What is the most appropriate response by the nurse? a. "Thank you. I am having a busy day and I can use your help." b. "I'm sorry, but nurses are responsible for all patient assessment." c. "How long have you been a CNA?" d. "If you will obtain the vital signs and place them in the chart then that would be a big help."