An AP reports a postoperative client's dressing is saturated with blood. What task should the nurse delegate to the AP?

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Question 1 of 5

An AP reports a postoperative client's dressing is saturated with blood. What task should the nurse delegate to the AP?

Correct Answer: B

Rationale: The correct answer is B: Obtain vital signs. Vital signs are essential in assessing the client's overall condition and detecting signs of hemorrhage or shock. Delegating this task to the AP allows the nurse to prioritize immediate assessment and intervention. Changing the dressing (A) requires sterile technique and assessment skills. Palpating for bladder distention (C) and observing the incision site (D) require more advanced assessment skills and interpretation, which should be done by a licensed nurse.

Question 2 of 5

A nurse is planning care for a client who has anorexia nervosa. The nurse should make which of the following client goals the priority?

Correct Answer: A

Rationale: The correct answer is A because attaining a healthy weight is crucial in treating anorexia nervosa to address malnutrition and restore physical health. Weight restoration is a primary goal to prevent serious medical complications and improve overall well-being. Choices B, C, and D are important aspects of treatment but may not be as critical as achieving a healthy weight for a client with anorexia nervosa. Making positive statements about body image, feeling in control of behavior, and identifying family changes are important for the client's mental and emotional well-being, but without addressing the physical aspect of malnutrition, the client's health remains at risk.

Question 3 of 5

An RN from the maternal-newborn unit is being floated to a medical-surgical unit. Which of the following clients should the charge nurse on the medical-surgical unit plan to assign to the RN?

Correct Answer: C

Rationale: The correct answer is C because the RN from the maternal-newborn unit would have experience in postoperative care and would be familiar with the care needs of a client one-day postoperative following a total abdominal hysterectomy. This assignment aligns with the nurse's skill set and background, ensuring safe and competent care delivery. Choice A is incorrect because a client with terminal end-stage renal disease would require specialized care typically provided by nurses with nephrology experience. Choice B is incorrect as acute pancreatitis management often requires specific interventions and monitoring that may not be within the RN's expertise from a maternal-newborn unit. Choice D is also incorrect as a client who had a stroke may require neurological assessments and interventions that the RN may not be prepared to provide.

Question 4 of 5

A nurse tells another nurse that she thinks he did not provide adequate care for a client who underwent hip arthroplasty. Which of the following responses by the nurse demonstrates assertiveness?

Correct Answer: A

Rationale: Answer A is correct as it demonstrates assertiveness by acknowledging the concern raised and seeking clarification in a non-defensive manner. By expressing openness to feedback and asking for more information, the nurse shows a willingness to address the issue constructively. This approach promotes communication and collaboration in resolving the situation. Answer B is incorrect as it responds defensively and shifts the focus to criticizing the accuser rather than addressing the concern raised. Answer C is incorrect as it does not address the issue at hand and does not demonstrate assertiveness in seeking to understand the specific concerns raised. Answer D is incorrect as it assumes a defensive stance and implies a personal attack, which is not conducive to resolving the issue professionally.

Question 5 of 5

A nurse is triaging clients following a mass casualty event. Which of the following clients should the nurse assess first?

Correct Answer: C

Rationale: The nurse should assess the client with severe respiratory stridor and a deviated trachea first because this indicates a compromised airway, which is the priority in emergency situations. Airway compromise can quickly lead to respiratory distress and potentially respiratory failure. Assessing and managing the airway takes precedence over other injuries to ensure the client's ability to breathe. The other choices, such as open fracture, head injury with seizures, and a small burn, while important, do not pose an immediate threat to the client's airway and can be addressed after ensuring airway patency.

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