A nurse enters a client's room and finds the client pulseless. The family has requested a do-not-resuscitate (DNR) order from the provider, but he has not written the order yet. Which of the following actions should the nurse take?

Call the provider for a stat DNR order.

Call the emergency response team.

Seek immediate help from the risk manager.

Respect the family's wishes and do nothing.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Call the provider for a stat DNR order is not appropriate as the client is already in a critical state requiring immediate action.

B. Call the emergency response team is necessary as the client is pulseless, and resuscitation should be initiated according to standard procedures until a DNR order is confirmed.

C. Seek immediate help from the risk manager is not appropriate at this moment; the immediate concern is the client's emergency situation.

D. Respect the family's wishes and do nothing is not appropriate as immediate life-saving measures should be taken until a formal DNR order is in place.

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Correct Answer is C

Explanation

Rationale:

A. Discussing the LPN's behavior with other nurses could potentially lead to gossip and does not address the core issue.

B. The charge nurse does not have authority to review personnel files; this is handled by management or HR.

C.The most appropriate first step is to investigate the client concerns directly. This provides objective information to determine if further action (coaching, reassignment, reporting to management) is necessary.

D. Reassigning client care to assistive personnel does not address the root cause of the problem and may not be an appropriate or effective solution without further investigation.

A. Ambulate an older adult client who has hypertension. B. Provide discharge instructions for a client who has a new skin graft. C. Check a blood product with another nurse prior to administration. D. Weigh a client who has heart failure. E. Perform an admission assessment on a client.

Correct Answer is ["A","D"]

Explanation

Rationale:

A. Ambulate an older adult client who has hypertension is a task that an AP can perform, provided the client is stable and has been assessed by the nurse.

B. Provide discharge instructions for a client who has a new skin graft is a task that requires nursing judgment and cannot be delegated to an AP.

C. Check a blood product with another nurse prior to administration is a nursing responsibility that requires verification by licensed personnel and cannot be delegated to an AP.

D. Weigh a client who has heart failure is appropriate for an AP, as it involves routine measurement that can be delegated.

E. Perform an admission assessment on a client is a nursing responsibility and cannot be delegated to an AP.

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A nurse enters a client's room and finds the client pulseless. The family has requested a do-not-resuscitate (DNR) order from the provider, but he has not written the order yet. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A charge nurse has assigned a group of clients to a licensed practical nurse (LPN). The charge nurse receives reports from her assigned clients about the LPN's lack of care. Which of the following actions should the charge nurse take?

Correct Answer is C

Explanation

A nurse is planning to assign tasks for a group of clients. Which of the following tasks should the nurse plan to assign to an assistive personnel (AP)? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

A nurse is obtaining informed consent from a client who is preoperative. Which of the following actions should the nurse take? (Select all that apply.)

A nurse manager is reviewing the admission history of four adults who were admitted to the medical-surgical unit during the shift. Which of the following situations is the nurse required to disclose information to an outside agency about the client or the client's circumstances?

A nurse is providing discharge teaching for a client who has a new prescription for home oxygen. Which of the following instructions should the nurse include in the teaching?

A nurse is assessing a group of clients for hospice services. The nurse should recommend hospice care for which of the following clients?

A nurse in a provider's office is reviewing the laboratory findings for a client who is scheduled for surgery. Which of the following findings requires follow up by the nurse?

A nurse is working with an assistive personnel (AP) to care for a group of clients on the pediatric unit. Which of the following tasks should the nurse have the AP perform first?

A nurse manager has received information from the facility's risk management department that a former client is pursuing a lawsuit. The nurse manager should anticipate a deposition will be required during which phase of the legal process?

A nurse is planning care for a client who has anorexia nervosa. The nurse should make which of the following client goals the priority?