A nurse is caring for a client who has visual loss. Which of the following actions should the
nurse implement?
Count steps to the bathroom with the client.
The nurse should orient the client to the room by counting the steps to the bathroom to reduce
the risk for falls.
A nurse is teaching a newly licensed nurse about preventing a catheter-associated urinary tract
infection for a client who has an indwelling urinary catheter. Which of the following instructions
should the nurse include?
Ensure the urinary catheter tubing is not kinked.
The nurse should instruct the newly licensed nurse to make certain the catheter tubing is free of
kinks, which could cause a blockage of urinary flow and result in a urinary tract infection.
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:00
/
0:15
Full screen
Brainpower
Read More
A nurse is caring for a client who is receiving brachytherapy for cancer. Which of the following
actions should the nurse take?
Ensure visitors remain at least 1.8 m (6 ft) from the client.
The nurse should instruct visitors to remain at least 1.8 m from the client who is receiving
radiation. Each visitor should limit visiting time to 30 min per day. Clients who are pregnant or
children under the age of 16 years should not be allowed to visit the client due to radiation
exposure.
, A nurse is caring for a client who has HIV. Which of the following precautions should the nurse
take?
Request the removal of fresh fruits and vegetables from the client's meal tray.
The nurse should request no fresh fruits or vegetables be placed on the client's meal trays.
Fresh fruit and vegetables contain bacteria that can place the client who is
immunocompromised at risk for infection.
A nurse is teaching a client who is to have a transurethral resection of the prostate (TURP) with
continuous bladder irrigation postoperatively. Which of the following statements by the client
should the nurse identify as an indication the client understands the teaching?
"After the catheter is removed, I can expect to experience some burning when I urinate."
The nurse should tell the client to expect some burning, urinary frequency, dribbling, and
leakage of urine after the urinary catheter is removed, but that these manifestations will
decrease with time. The client is taught perineal exercises to decrease urinary incontinence.
A nurse is caring for a client who has a traumatic brain injury from a motor vehicle crash. Which
of the following findings indicates to the nurse the client is experiencing an increase in
intracranial pressure?
Dilated pupils
The nurse should identify that a client who has a traumatic brain injury and pupils that are
dilated or fixed might be experiencing an increase in intracranial pressure. The pupils can also
become dilated and nonreactive, and other brain stem reflexes can be lost.
A nurse is preparing to administer a reversal agent to a client who is somnolent and has a
respiratory rate of 6/min after receiving morphine IV. Which of the following medications should
the nurse plan to administer to reverse the effects of the morphine?
Naloxone
The nurse should plan to administer naloxone to reverse the effects of the morphine. Naloxone
is an opioid antagonist used to reverse morphine's adverse effects of sedation, euphoria, and
respiratory depression that can lead to a coma.
note:
The nurse should plan to administer flumazenil to a client who is over sedated from a
benzodiazepine medication.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ALICE12. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.99. You're not tied to anything after your purchase.