A registered nurse (RN) is supervising a nursing assistant ambulating a client with right-sided weakness. The RN would conclude that the nursing assistant is performing the procedure incorrectly after observing that the nursing assistant:
A. Stands behind the client
B. Stands on the right side of the client
C. Positions the free hand on the client's shoulder
D. Grasps the security belt in the midspine area of the small of the client's back
Answer: A. Stands behind the client
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A businesswoman who is leaving on a business trip the next day tells the nurse she knows she has cystitis and does not want to have to "mess" with medicine while she is gone. What drug would be a good choice for this patient?
A) Fosfomycin (Monurol) B) Methenamine (Hiprex) C) Nitrofurantoin (Furadantin) D) Norfloxacin (Noroxin)
A patient on the medical unit is receiving a unit of PRBCs. Difficult IV access has necessitated a slow infusion rate and the nurse notes that the infusion began 4 hours ago. What is the nurse's most appropriate action?
A) Apply an icepack to the blood that remains to be infused. B) Discontinue the remainder of the PRBC transfusion and inform the physician. C) Disconnect the bag of PRBCs, cool for 30 minutes and then administer. D) Administer the remaining PRBCs by the IV direct (IV push) route.
A client with hypothyroidism is taking levothyroxine sodium (Synthroid). The nurse concludes that the client has met a goal of care when the client states:
1. "I should notify the physician if my heart rate is 70." 2. "I should eat a low-fiber diet." 3. "I should report unusual weight gain." 4. "I should not take Synthroid with antacids."
A mother brings her child to the clinic for his last diphtheria-pertussis-tetanus (DPT) immunization. The mother tells the nurse that the child developed a red rash after the previous diphtheria-pertussis-tetanus (DPT) immunization
What does the best action by the nurse include? 1. Administer only a pertussis-tetanus immunization. 2. Withhold this immunization and contact the physician. 3. Tell the mother to give the child acetaminophen (Tylenol) if another rash develops. 4. Administer diphenhydramine (Benadryl) prior to the diphtheria-pertussis-tetanus (DPT) immunization.