It is most important for the registered nurse (RN) who is working on a medical unit to provide direct supervision in which situation?

A practical nurse is preparing to assist the healthcare provider with a lumbar puncture at the bedside.

A postpartum nurse pulled to the unit needs to start a transfusion of packed red blood cells.

An unlicensed assistive personnel is preparing to weigh an obese bedfast client using a bed scale.

A graduate nurse needs to access a client's implanted port to start an infusion of Ringer's Lactate.

Answer and Explanation

The Correct Answer is A

Choice A: A practical nurse assisting the healthcare provider with a lumbar puncture at the bedside is a high-risk procedure that requires direct supervision by an RN or a qualified healthcare provider. The RN should ensure the procedure is performed safely and effectively, as it involves potential risks and complications.

Choice B: Starting a transfusion of packed red blood cells is an important nursing intervention, but it does not necessarily require direct supervision by an RN, especially if the nurse has been trained and is competent in administering blood transfusions.

Choice C: Weighing an obese bedfast client using a bed scale is a routine nursing task that can be performed by unlicensed assistive personnel (UAP) with appropriate training. While the RN should ensure that the UAP is properly trained, direct supervision may not be required for this specific task.

Choice D: Accessing a client's implanted port to start an infusion of Ringer's Lactate is a nursing task that can be performed by a graduate nurse, especially if they have received appropriate training and competency validation. Direct supervision by an RN may not be necessary in this situation.

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Correct Answer is D

Explanation

Choice A: A mechanical soft diet may still require some degree of chewing, which may be difficult for a client with no teeth. A pureed diet would be a more appropriate choice.

Choice B: A soft low-residue diet may include soft foods that require chewing, which could be challenging for a client with no teeth.

Choice C: A full liquid diet consists of liquids and foods that are in liquid form at room temperature, which may not provide adequate nutrition for the client.

Choice D: A pureed diet involves blending foods to a smooth consistency, making them suitable for clients with no teeth or difficulty chewing. It would be the most appropriate choice.

A. Increased Ca+ influx with sympathetic stimulation that raises the heart rate. B. Sympathetic activation boosts K+ efflux and increases the inotropic effect. C. Sympathetic activation decreases dromotrophy by lowering conduction speed. D. Increased Na+ influx with sympathetic stimulation reduces pacemaker firing.’

Correct Answer is A

Explanation

Choice A: Increased Ca+ influx with sympathetic stimulation that raises the heart rate is a manifestation of sympathetic innervation. Sympathetic activation leads to the release of norepinephrine, which enhances the influx of calcium ions (Ca+) into cardiac muscle cells, resulting in increased contractility and heart rate.

Choice B: Sympathetic activation does increase the inotropic effect (contractility) of the heart, but it is primarily mediated by the increased influx of calcium ions (Ca+).

Choice C: Sympathetic activation does not decrease dromotrophy (conduction speed). Instead, it can increase the conduction speed through the cardiac conduction system.

Choice D: Increased Na+ influx with sympathetic stimulation does not reduce pacemaker firing; instead, it contributes to the enhanced excitability and automaticity of cardiac cells.

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It is most important for the registered nurse (RN) who is working on a medical unit to provide direct supervision in which situation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During the admission assessment, an older male client who has no teeth tells the nurse that he cannot find his dentures at home. His dietary prescription is a regular diet. What diet request should the nurse recommend for this client?

Correct Answer is D

Explanation

Which pathology of autonomic cardiac regulation is mediated by sympathetic innervation?

Correct Answer is A

Explanation

An adolescent hospitalized with sickle cell anemia reports to the nurse of experiencing a pain level of 10 on a 0 to 10 numerical scale. The nurse observes the adolescent on a phone call laughing. Which action should the nurse take?

The nurse is reviewing a nutrition plan with a client newly diagnosed with hypertension. Which statement by the client indicates an understanding of the Dietary Approaches to Stop Hypertension (DASH) diet?

The nurse is caring for an older client with that is exhibiting signs of confusion. Which intervention should the nurse implement?

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The healthcare provider hands a newborn to the circulating nurse during a cesarean delivery. What action should the nurse implement first?

The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?