Nursing Prioritization, Delegation, Assignment Question and Answers 2023, Exams of Nursing

Download Nursing Prioritization, Delegation, Assignment Question and Answers 2023 and more Exams Nursing in PDF only on Docsity! Perform postural drainage and chest physiotherapy every 4 hours. Airway clearance techniques are critical for patients with cystic fibrosis and should take priority over other activities. The Cystic Fibrosis Transmembrane Conductance Regulator defect causes mucus to become dehydrated. Secretions in cystic fibrosis are generally thick, sticky, and more difficult to clear. Frequent airway clearance is a mainstay in the treatment of acute exacerbations, as well as an integral part of health maintenance in cystic fibrosis. Nursing Prioritization, Delegation, Assignment Question and Answers 2023 Nursing Prioritization, Delegation, Assignment 1. Question A 16-year old patient with cystic fibrosis is admitted with increased shortness of breath and possible pneumonia. Which nursing activity is most important to include in the patient’s care? 2. Question A patient with a pulmonary embolism is receiving anticoagulation with IV heparin. What instructions would you give the nursing assistant who will help the patient with activities of daily living?  Risk for bleeding may arise in any condition that disturbs the “close circuit” integrity of the circulatory system. Bleeding is the primary complication of anticoagulant therapy and is a risk of all anticoagulants even when maintained within the usual therapeutic ranges.  Educate the at-risk patient about precautionary measures to prevent tissue trauma or disruption of the normal clotting mechanisms. Information about precautionary measures lessens the risk for bleeding.  Be careful when using sharp objects like scissors and knives. Use an electric razor for shaving (not razor blades). The patient needs to avoid situations that may cause tissue trauma and increase the risk for bleeding.  Use a soft-bristled toothbrush and nonabrasive toothpaste. Avoid the use of toothpicks and dental floss. This method providing oral hygiene reduces trauma to oral mucous membranes and the risk for bleeding from the gums. A 72-year old who needs teaching about the use of incentive spirometry Many surgical patients are taught about coughing, deep breathing, and the use of incentive spirometry preoperatively. The needs of the client must be competently met with the knowledge, skills and abilities of the staff to meet these needs. In other words, the nurse who delegates aspects of care to other members of the nursing team must balance the needs of the client with the abilities of those to which the nurse is delegating tasks and aspects of care. provides a direct access route for bacteria or viruses to the lower part of the respiratory system. 8. Question An experienced LPN, under the supervision of the team leader RN, is providing nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN?  The experienced LPN is capable of gathering data and making observations, including noting breath sounds and performing pulse oximetry. The scope of practice for the licensed practical or vocational nurse will most likely include the legal ability of this nurse to perform data collection, plan, implement, and evaluate care under the direct supervision and guidance of the registered nurse.  Administering medications, such as those delivered via MDIs, is within the scope of practice of the LPN. Based on the basic entry educational preparation differences among these members of the nursing team, care should be assigned according to the level of education of the particular team member. 9. Question The charge nurse is making assignments for the next shift. Which patient should be assigned to the fairly new nurse (6 months experience) pulled from the surgical unit to the medical unit?  A. A 58-year old on airborne precautions for tuberculosis (TB).  B. A 68-year old just returned from bronchoscopy and biopsy.  C. A 72-year old who needs teaching about the use of incentive spirometry.  D. A 69-year old with COPD who is ventilator dependent. Manually ventilate the patient while assessing possible reasons for the high- pressure alarm Manual ventilation of the patient will allow you to deliver a FiO2 of 100% to the patient while you attempt to determine the cause of the high-pressure alarm. Proper ventilation techniques with the BVM should consider safe ventilation parameters for each individual patient and their conditions. Suggest that the patient’s oxygen be humidified. When the oxygen flow rate is higher than 4 L/min, the mucous membranes can be dried out. The best treatment is to add humidification to the oxygen delivery system. It is reasonable to use humidified oxygen for patients who require high- flow oxygen systems for more than 24 hours or who report upper airway discomfort due to dryness. Application of a water-soluble jelly to the nares can also help decrease mucosal irritation. Surfactant (Exosurf) Exosurf neonatal is a form of synthetic surfactant. An infant with RDS may be given two to four doses during the first 24 to 48 hours after birth. It improves respiratory status, and research has shown a significant decrease in the incidence of pneumothorax when it is administered. 10. Question The high-pressure alarm on a patient’s ventilator goes off. When you enter the room to assess the patient, who has ARDS, the oxygen saturation monitor reads 87% and the patient is struggling to sit up. Which action should you take next? 11. Question The nursing assistant tells you that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should you suggest to improve the patient’s comfort for this problem? 12. Question To improve respiratory status, which medication should you be prepared to administer to the newborn infant with respiratory distress syndrome (RDS)? 13. Question The clinical instructor directed the student nurse to care for a client whose potassium is 6.7 mEq/L. Which intervention is delegated correctly to the student nurse? Observe how well the patient performs pursed-lip breathing Experienced LPNs/LVNs can use observation of patients to gather data regarding how well patients perform interventions that have already been taught. The scope of practice for the licensed practical or vocational nurse will most likely include the legal ability of this nurse to perform data collection, plan, implement and evaluate care under the direct supervision and guidance of the registered nurse. Switch the patient to a nonrebreather mask at 95% to 100% oxygen and call the physician to discuss the patient’s status. The patient’s history and symptoms suggest the development of ARDS, which will require intubation and mechanical ventilation. Patients are mechanically ventilated, guarded against fluid overload with diuretics, and given nutritional support until evidence of improvement is observed. Give sodium polystyrene sulfonate (Kayexalate) 15 g orally Delegation, supervision. The normal range for potassium is 3.5 to 5 mEq/L. The client’s potassium level is high. Kayexalate eliminates potassium from the body through the gastrointestinal system. The right person must be assigned to the right tasks and jobs under the right circumstances. The nurse who assigns the tasks and jobs must then communicate with and direct the person doing the task or job. 14. Question The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN under your supervision? 15. Question When assessing a 22-year old patient who required emergency surgery and multiple transfusion 3 days ago, you find that the patient looks anxious and has labored respirations at the rate of 38 breaths/min. The oxygen saturation is 90% with the oxygen delivery at 6 L/min via nasal cannula. Which action is most appropriate? 16. Question You are a team leader RN working with a student nurse. The student nurse is to teach a patient how to use an MDI without a spacer. Put in the correct order the steps that the student nurse should teach the patient.