The nurse cares for an elderly patient in a long-term care center. Which would be inappropriate for the nurse to share with the client?

Correct Answer: B

Rationale: The correct answer is B because using high levels of intimacy with a client in a professional setting is inappropriate and can violate boundaries. The nurse should maintain a professional relationship with the client to ensure ethical standards are upheld. A: Reminiscing about birthday celebrations is appropriate as it can help build rapport and show empathy towards the client. C: Sharing a personal story to establish trust is acceptable as long as it is relevant to the client's situation and does not breach confidentiality. D: Sharing information about meditation decreasing nausea during chemotherapy treatment is relevant and can provide valuable support to the client.

Correct Answer: A

Rationale: The correct answer is A because asking the client how they are feeling can provide valuable information about their current condition. It allows the team leader to assess the client's subjective well-being, any immediate concerns, and potential changes in health status. Noting mental status (choice B) and measuring vital signs (choice C) are not typically part of a brief assessment before shift report. Palpating chest and abdominal areas for pain (choice D) would require more thorough assessment and is not necessary during brief rounds.

Correct Answer: D

Rationale: The correct answer is D because addressing the client's concerns directly with the healthcare provider (HCP) is the most immediate and effective way to ensure proper infection control procedures are followed. By approaching the HCP and explaining the client's observations and concerns, the team leader can facilitate communication and potentially prevent any lapses in infection control. This action promotes patient safety and trust in the healthcare team. Choice A is incorrect because assuming the HCP washed hands without confirmation can lead to overlooking potential gaps in infection control. Choice B is incorrect as it does not address the client's specific observation and concerns. Choice C is not the priority as contacting infection control should come after addressing the issue with the HCP directly.

Correct Answer: C

Rationale: The correct answer is C: Bag-valve mask with extension tubing. This is the most important equipment to show to the student because it is essential for providing immediate ventilation support in case of respiratory distress for a patient with a tracheostomy or partial laryngectomy. The bag-valve mask allows for manual ventilation by delivering oxygen to the patient's lungs, and the extension tubing ensures easy access to the patient's airway. A: An adult-sized endotracheal tube is not the most important equipment in this scenario as the patient already has a tracheostomy in place. B: A laryngeal scope with blades of several sizes is used for visualizing the larynx and not essential for immediate respiratory support. D: A tracheostomy insertion tray is used for performing tracheostomy procedures and not required for routine emergency respiratory support. In summary, the bag-valve mask with extension tubing is the most critical equipment for immediate ventilation support

Correct Answer: C

Rationale: The correct answer is C: 3 days. After BCG treatment for bladder cancer, it is crucial for the healthcare provider (HCP) to be notified if a normal voiding pattern does not resume within 3 days. This timeframe allows for monitoring any potential complications or urinary retention post-catheter removal. Option A (6 hours) is too short for significant changes to occur, option B (12 hours) is also too soon to assess the situation comprehensively, and option D (1 week) is too long to wait for potential issues to be addressed promptly. Therefore, option C is the most appropriate time frame for early intervention if the patient experiences any urinary difficulties post-catheter removal.