One of the highest priorities of nursing care is:

maintaining skin integrity

adequate nutrition

pain control

airway management

Answer and Explanation

The Correct Answer is D

A. Maintaining skin integrity:
Maintaining skin integrity is crucial for preventing pressure ulcers and other skin-related issues, especially for patients who are bedridden or have limited mobility. Preventive measures, like turning the patient regularly and keeping the skin clean and dry, are essential. While important, it is not always the highest priority and can be managed alongside other nursing interventions.

B. Adequate nutrition:
Providing adequate nutrition is vital for the patient's overall health and recovery. Malnutrition can impair the healing process and weaken the immune system. However, in immediate critical situations, addressing the airway, breathing, and circulation (ABCs) takes precedence over nutritional concerns. Once the patient is stable, addressing nutrition becomes a priority in the nursing care plan.

C. Pain control:
Managing pain is crucial for a patient's comfort and well-being. Uncontrolled pain can cause anxiety, impair healing, and decrease the overall quality of life. Pain control is a high priority, but in certain emergencies where the patient's airway or circulation is compromised, managing pain might be temporarily secondary until the primary issues are addressed.

D. Airway management:
Ensuring a clear airway is often the highest priority in emergency situations. Without a patent airway, the patient cannot breathe effectively, leading to oxygen deprivation and potential cardiac arrest. Nurses and healthcare providers focus on maintaining or establishing a clear airway to ensure the patient can breathe adequately. Once the airway is secured, attention can be directed to other aspects of care.

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Correct Answer is ["2 "]

Explanation

First, let's find out how many milliliters (ml) are needed for a 180 mg dose using the given supply:

{Dose needed} = 180 mg

Supply concentration = 30 mg/5ml

Using the formula:

Volume (ml) = Dose needed (mg/ Supply concentration (mg/ml)

Substituting the values:

Volume (ml) = 180 mg/ 30 mg/5ml

Volume (ml) = (180mg*5ml)/30mg

Volume (ml) = 900/30 ml

Volume (ml) = 30ml

Now, one tablespoon is equal to 15 ml. So, to convert 30 ml to tablespoons:

Number of tablespoons = 30ml/ 15ml

Number of tablespoons = 2

The nurse would give 2 tablespoons.

A. a semi-dependent nursing action. B. an independent nursing action C. a dependent nursing action D. an interdependent nursing action.

Correct Answer is B

Explanation

A. A semi-dependent nursing action: This term doesn't have a standard meaning in nursing. Nursing actions are generally categorized as independent, dependent, or interdependent.

B. An independent nursing action: Independent nursing actions are activities that nurses are licensed to initiate on the basis of their knowledge and skills. These actions don't require a physician's order. Giving a back massage, in many cases, falls under the category of independent nursing actions. Nurses often assess the patient's condition and, if appropriate, can provide interventions like massages to enhance comfort and well-being without needing a specific order.

C. A dependent nursing action: Dependent nursing actions are activities that require a physician's order or another healthcare provider's directive. Nurses perform these actions under the physician's supervision or guidance. Giving a back massage might require a specific order in certain situations, for instance, if the patient has a particular condition that necessitates a tailored approach to massage.

D. An interdependent nursing action: Interdependent nursing actions are those that require collaboration with other healthcare team members. These actions involve working together with physicians, therapists, and other professionals to ensure comprehensive patient care. While collaboration is essential in healthcare, giving a back massage is generally not considered primarily interdependent; it's more about the nurse's individual skill unless there are specific medical considerations that require interprofessional collaboration.

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One of the highest priorities of nursing care is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The dose is 180mg. The supply is 30mg/5ml. How many tablespoons does the nurse give?

Correct Answer is ["2 "]

Explanation

The nurse giving a patient a back massage is performing an intervention considered to be:

Correct Answer is B

Explanation

Preparing a patient for a diagnostic test, and telling the patient what to expect during and after the test, is considered:

To begin talking with a newly admitted patient about pain management, the nurse would most appropriately state:

When the nurse checks to see whether a patient is still having pain. 45 minutes after administering pain medication, the nurse is performing which part of the nursing process?

Helpful cultural information the nurse should include on the admission note is: (Select all that apply.)

A resident in a nursing home complains of constipation. The nurse checks the patient record and notes that he has not had a bowel movement in three days. She/he then performs a digital rectal exam and feels hard stool. Which part of the nursing process is this?

The general rule is that the initial care plan for a patient is:

A review of a patient nursing care plan before beginning care allows the nurse to

The nurse is caring for a patient who complains of a headache. This is an example of which type of data?