A nurse is planning care for a client who has a prescription for a bowel-training program following a spinal cord injury. Which of the following actions should the nurse include in the plan of care?

A nurse is caring for a client in a clinic.

Vital Signs 0915:

Temperature 36.7° C (98° F)

BP 122/80 mm Hg Respiratory rate 20/min Heart rate 99/min

Nurses' Notes 0900:

A 16-year-old client reports to the clinic with their caregiver. The client's caregiver informs the nurse that the client has "not been themselves lately." The client's parents and a sibling passed away from injuries sustained when a tornado moved through their town 1 month ago. They were the only survivors and witnessed their family's deaths.

0910:

The client appears anxious but answers appropriately for age. They report experiencing nightmares that awaken them at night and startle easily during thunderstorms, but the client admits that they have always been afraid of thunderstorms. The client admits to smoking marijuana for about 1 month because it helps clear their mind. They also admit that they have no desire to leave the house. They attend school regularly and are on the honor roll.

Based on the information in the client's medical record, which of the following findings requires immediate follow-up?

Select the 4 findings that require follow-up.

A nurse is caring for a client who has experienced a stroke and is moving in with their adult child. Which of the following actions should the nurse encourage the client and family to take as they adjust to their new roles?

A nurse inadvertently administered 160 mg of valsartan PO to a client who was scheduled to receive 80 mg. Which of the following actions is the priority for the nurse to take?

A nurse is caring for a client who is postoperative following a right hip arthroplasty.

Vital Signs

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1330:

Temperature 36.8° C (98.2° F) Heart rate 88/min

Respiratory rate 16/min BP 110/64 mm Hg

Oxygen saturation 96% on oxygen 3 U/min via simple face mask 1345:

Temperature 37° C (98.6" F) Heart rate 112/min Respiratory rate 20/min

BP 108/60 mm Hg

Oxygen saturation 94% on oxygen 3 L/min via simple face mask 1400

Temperature 38.3° C (101° F) Heart rate 152/min Respiratory rate 26/min

BP 90/54 mm Hg

Oxygen saturation 89% on oxygen 4 Umin a simple face mask

For each assessment finding, specify if the finding is consistent with malignant hyperthermia, latex allergy, or hypovolemic shock. Each finding may support more than 1 disease process

A nurse is administering furosemide IV bolus to a client who has fluid volume excess. The nurse should recognize which of the following findings as an indication that the medication has been effective?

174. A nurse is caring for a client who requires nasotracheal suctioning. Identify the sequence the nurse should follow to perform suctioning. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

A case manager is meeting with a client who asks about using alternative therapies to manage her rheumatoid arthritis. Which of the following statements should the nurse make?

A nurse is planning care for a client who has bipolar disorder and is experiencing mania.
Which of the following interventions should the nurse include in the plan?

A nurse at a health department is providing anticipatory guidance to the parent of a 1-month-old infant.
The nurse should inform the parent that the infant should receive which of the following immunizations at the age of 2 months?

A nurse is caring for a client in the medical-surgical unit.

Which of the following actions should the nurse take to decrease the risks for urinary tract infection for this client?
Select all that apply.