nursing 1025 fundamentals of nursing
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A nurse is documenting in a client's health record using the problem-intervention-evaluation charting model (PIE). Which of the following information should be included in the intervention component?
- Client had 150 mL of emesis in last hour
- Client is asleep and resting
- Ondansetron 4 mg IV bolus for nausea and vomiting
- Client reports nausea and vomiting 30 minutes following surgery
Explanation
Correct Answer: C) Ondansetron 4 mg IV bolus for nausea and vomiting.
The PIE charting model is a structured documentation format consisting of three components: Problem, Intervention, and Evaluation. The Problem component identifies the client's nursing diagnosis or clinical issue. The Intervention component documents the specific nursing actions taken to address the identified problem. The Evaluation component records the client's response to those interventions.
Administering Ondansetron 4 mg IV bolus is a direct nursing intervention taken in response to the client's nausea and vomiting, making it the correct entry for the intervention section. Documenting 150 mL of emesis and the client reporting nausea and vomiting are objective and subjective assessment data that belong in the Problem component. Noting that the client is asleep and resting is an evaluative observation that would be more appropriately placed in the Evaluation component, as it describes the client's current status following intervention.
A charge nurse is teaching a newly licensed nurse about fall prevention strategies when caring for clients. Which of the following information should the nurse include in the teaching? (Select all that apply.)
- Lock the wheels on the bed.
- Apply socks on clients when ambulating.
- Place breaks on the clients' wheelchairs.
- Keep the bed in the high position.
- Provide under-bed lighting at night.
Explanation
Correct Answer: A) Lock the wheels on the bed, C) Place brakes on the clients' wheelchairs, and E) Provide under-bed lighting at night.
Locking the wheels on the bed is a fundamental fall prevention measure that stabilizes the bed and prevents it from rolling when a client attempts to get up, significantly reducing the risk of falls during transfers. Placing brakes on wheelchairs similarly immobilizes the chair during transfers, preventing the wheelchair from sliding away from under the client. Providing under-bed lighting at night addresses one of the most common causes of patient falls — poor visibility during nighttime ambulation to the bathroom. Low-level lighting illuminates the floor without disrupting sleep, allowing clients to safely navigate their environment.
A nurse is teaching a newly licensed nurse about reducing the risk of needlestick injuries. Which of the following instructions should the nurse include?
- Bend needles without safety devices before disposing of them.
- Engage the safety device immediately after using a needle.
- Use sharps containers until they are completely full.
- Dispose of large-bore needles into waterproof wastebaskets.
Explanation
Correct Answer: B) Engage the safety device immediately after using a needle.
Engaging the safety device immediately after needle use is a standard and evidence-based practice to prevent needlestick injuries. Safety-engineered devices are designed to shield the needle tip right after withdrawal, minimizing the risk of accidental puncture to the nurse or other healthcare workers.
A nurse is obtaining a health history from a client. Which of the following findings should the nurse identify as a modifiable risk factor for developing a disease?
- Family history
- Genetics
- Sunbathing
- Age
Explanation
Correct Answer: C) Sunbathing.
A modifiable risk factor is one that a person can change or control through behavior, lifestyle choices, or medical intervention. Sunbathing is a modifiable risk factor because it is a deliberate behavior that significantly increases the risk of skin cancer and other UV-related conditions — and it can be reduced or eliminated through behavioral changes such as using sunscreen, wearing protective clothing, and limiting sun exposure. The distinction between modifiable and non-modifiable risk factors is clinically important because health promotion and disease prevention efforts are focused on helping clients reduce their modifiable risks.
A nurse is discussing a multistate license with a newly licensed nurse. Which of the following statements should the nurse make? Select All that Apply.
- "You can work as a travel nurse."
- "You can practice nursing as a telehealth nurse."
- "You will need to pay for additional licenses to obtain this benefit."
- "You will be able to respond to natural disasters in other states."
- "You can work in other states if needed due to relocation."
Explanation
Correct Answers: A) "You can work as a travel nurse." B) "You can practice nursing as a telehealth nurse." D) "You will be able to respond to natural disasters in other states." E) "You can work in other states if needed due to relocation."
A) Travel nurse — A multistate license under the Nurse Licensure Compact (NLC) allows nurses to practice in any of the compact member states without obtaining additional individual state licenses, making it highly beneficial for travel nurses who move between states for short-term assignments.
B) Telehealth nurse — Telehealth nursing often involves providing care to clients located in different states than where the nurse is physically located. A multistate license permits the nurse to legally practice across state lines in this capacity, which is essential for telehealth practice.
D) Natural disasters — During declared emergencies and natural disasters, nurses with multistate licenses can be rapidly deployed to affected compact states to provide care without the administrative delay of obtaining emergency licensure, making disaster response faster and more efficient.
E) Relocation — If a nurse relocates to another compact member state, their multistate license allows them to continue practicing nursing in the new state without immediately applying for a new state license, easing the transition.
A nurse is documenting assessment findings on a client. Which of the following entries should the nurse identify as subjective data? (Select all that apply.)
- Client reports the rash on their back is itchy.
- Client reports dull, aching pain in lower right calf.
- Client's oral temperature is 38.4° C (101.2° F).
- Client reports nausea following administration of pain medication.
- Client has a vesicular rash on their upper back.
Explanation
Correct Answer: A) Client reports the rash on their back is itchy, B) Client reports dull, aching pain in lower right calf, and D) Client reports nausea following administration of pain medication.
Subjective data is information that is perceived and reported by the client and cannot be directly observed or measured by the nurse — it represents the client's personal experience of symptoms. Itchiness, pain, and nausea are all sensations that only the client can feel and describe, making them inherently subjective. These types of symptoms are sometimes referred to as symptoms in clinical terminology, as opposed to signs, which are objectively measurable. Accurately distinguishing subjective from objective data is fundamental to the nursing assessment process, as each type informs different aspects of clinical decision-making.
A nurse is teaching a newly licensed nurse about cleaning medical equipment. Which of the following instructions should the nurse include?
- Remove visible material from equipment before disinfecting.
- Use low-level disinfection on endoscopic equipment.
- Clean equipment soiled with organic material without protective eyewear.
- Use disinfectants to clean blood off of blood pressure cuffs.
Explanation
Correct Answer: A) Remove visible material from equipment before disinfecting.
Proper cleaning of medical equipment requires a sequential process that begins with the removal of all visible organic material, such as blood, tissue, or body fluids, before any disinfection or sterilization is attempted. This step is critical because organic material can act as a physical barrier that prevents disinfectants from reaching the surface of the equipment, rendering the disinfection process ineffective and leaving potentially infectious microorganisms on the equipment.
This initial cleaning step, known as pre-cleaning or decontamination, is a foundational principle of infection control. Endoscopic equipment, which enters sterile body cavities or comes into contact with mucous membranes, requires high-level disinfection or sterilization, not low-level disinfection. Cleaning equipment contaminated with organic material without protective eyewear violates standard precautions and puts the nurse at risk for exposure to bloodborne pathogens. Blood pressure cuffs are non-critical equipment that contact only intact skin and should be cleaned with appropriate surface disinfectants, not the same disinfectants used for blood-contaminated critical instruments
A nurse is teaching a class about alternative medicine. The nurse should include that which of the following practices uses diluted substances to stimulate the body to heal itself?
- Naturopathy
- Homeopathy
- Functional medicine
- Ayurveda
Explanation
Correct Answer: B) Homeopathy
Homeopathy is an alternative medicine practice based on the principle that highly diluted substances that cause symptoms in healthy individuals can stimulate the body's natural healing response in those who are ill. This "like cures like" philosophy with extreme dilution is the defining characteristic of homeopathy.
A nurse is planning to provide discharge teaching for a client who has hearing loss. Which of the following actions should the nurse plan to take?
- Face the client while talking.
- Answer client's question using medical terminology.
- Dim the lights in the client's room.
- Increase the rate of speech when talking with the client.
Explanation
Correct Answer: A) Face the client while talking.
When communicating with a client who has hearing loss, facing the client directly while speaking is an essential and evidence-based communication strategy. Many individuals with hearing loss rely on lip reading, facial expressions, and non-verbal cues to supplement their understanding of spoken words. By maintaining face-to-face positioning, the nurse ensures that the client has full visual access to these cues, which significantly enhances comprehension.
Additionally, the nurse should speak clearly at a normal or slightly slower pace, not faster, as increasing the rate of speech makes lip reading more difficult and reduces clarity. Dimming the lights would make lip reading and facial expression interpretation nearly impossible, further impairing communication. Using medical terminology is inappropriate for any client teaching as it creates confusion and reduces health literacy, regardless of hearing status.
A public health nurse is preparing an educational session at a community health center about the social determinants of health (SDOH). Which of the following information should the nurse include?
- SDOH are conditions in an individual's environment that affect their well-being.
- Identifying SDOH increases disparities in health care.
- SDOH are determined by an individual's ethnic background.
- SDOH include psychological factors.
Explanation
Correct Answer: A) SDOH are conditions in an individual's environment that affect their well-being.
The social determinants of health are the non-medical conditions and environmental factors in which people are born, grow, live, work, and age that have a profound impact on health outcomes and quality of life. According to the World Health Organization and Healthy People 2030, SDOH encompass five key domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. These factors, such as poverty, housing instability, food insecurity, lack of transportation, and limited access to education, shape an individual's health behaviors and outcomes more significantly than clinical care alone. Identifying and addressing SDOH actually reduces health disparities rather than increasing them, and they are not limited to ethnic background or psychological factors alone.
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