A nurse is preparing to give change-of-shift report to the oncoming nurse. Which of the following information should the nurse include?

Medical diagnosis.

Number of visitors.

Routine care.

Expected laboratory results.

Answer and Explanation

The Correct Answer is C

A bone scan that is scheduled for today. The nurse should include this information in the change-of-shift report because the oncoming nurse might have to modify the client’s care to accommodate leaving the unit.

Choice A is wrong because the client’s input and output for the shift are routine data that can be found in the client’s chart and do not need to be verbally reported.

Choice B is wrong because the client’s blood pressure from the previous day is not relevant to the current condition of the client and does not reflect any changes or interventions.

Choice D is wrong because the medication routine from the medication administration record is also routine data that can be accessed by the oncoming nurse and does not indicate any special needs or concerns.

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Correct Answer is B

Explanation

The indirect Coombs test is used to detect antibodies against foreign red blood cells in the maternal serum. This test can help identify maternal-fetal blood incompatibility, which can cause hemolytic disease of the newborn.

Choice A is wrong because homocysteine is a type of amino acid and is not related to blood compatibility.

Choice C is incorrect because erythropoietin is a hormone that regulates red blood cell production and is not a specific test for detecting maternal-fetal blood incompatibility.

Choice D is not the correct answer as aPTT (activated partial thromboplastin time) is a test used to evaluate blood clotting factors and is not directly related to monitoring maternal-fetal blood incompatibility.

A. Offer the client fluids high in fiber and protein every hour. B. Monitor the client’s vital signs twice per day. C. Encourage the client to participate in group therapy activities each day. D. Weigh the client three times per week.

Correct Answer is A

Explanation

Offer the client fluids high in fiber and protein every hour. This is because clients who have bipolar disorder and are experiencing mania are at risk of dehydration, malnutrition, and weight loss due to increased activity, poor intake, and impaired judgment. Fluids high in fiber and protein can help prevent constipation and promote satiety.

Choice B is wrong because monitoring the client’s vital signs twice per day is not enough for a client who has mania. The nurse should monitor the client’s vital signs more frequently, at least every 4 hours, to assess for signs of dehydration, infection, or cardiac complications.

Choice C is wrong because encouraging the client to participate in group therapy activities each day can increase the client’s stimulation and agitation. The nurse should provide a calming environment with fewer stimuli and solitary activities for a client who has mania.

Choice D is wrong because weighing the client three times per week is not sufficient for a client who has mania. The nurse should weigh the client daily to monitor for weight loss and fluid imbalance.

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A nurse is preparing to give change-of-shift report to the oncoming nurse. Which of the following information should the nurse include?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is pregnant and Rh-negative. The nurse should plan to monitor which of the following maternal laboratory test results to determine maternal-fetal blood incompatibility?

Correct Answer is B

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Correct Answer is A

Explanation

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