Question 1

Which of the following are direct care interventions?

Accepted Answer

A)  Turning a patient 
B)  Counseling a patient 
C)  Performing resuscitation 
D)  Documenting wound care 
E)  Teaching wound care 
A)  Turning a patient 
B)  Counseling a patient 
C)  Performing resuscitation 
D)  Documenting wound care 
E)  Teaching wound care

Question 2

Vital signs for a patient reveal a high blood pressure of 187/100.Orders state to notify the health care provider for diastolic blood pressure greater than 90.What is the nurse's first action?

Accepted Answer

A)  Assess the patient for other symptoms or problems, and then notify the health care provider. 
B)  Review the most recent lab results for the patient's potassium level. 
C)  Follow the clinical protocol for a stroke. 
D)  Administer an antihypertensive medication from the stock supply, and then notify the health care provider. 
A)  Assess the patient for other symptoms or problems, and then notify the health care provider. 
B)  Review the most recent lab results for the patient's potassium level. 
C)  Follow the clinical protocol for a stroke. 
D)  Administer an antihypertensive medication from the stock supply, and then notify the health care provider.

Question 3

Which intervention is most appropriate for a patient who has a new onset of chest pain?

Accepted Answer

A)  Administer a prn medication for pain. 
B)  Reassess the patient because of the change in condition. 
C)  Notify the health care provider. 
D)  Call radiology for a portable chest x-ray. 
A)  Administer a prn medication for pain. 
B)  Reassess the patient because of the change in condition. 
C)  Notify the health care provider. 
D)  Call radiology for a portable chest x-ray.

Exam 19: Implementing Nursing Care

Which of the following are direct care interventions?

Vital signs for a patient reveal a high blood pressure of 187/100.Orders state to notify the health care provider for diastolic blood pressure greater than 90.What is the nurse's first action?

Which intervention is most appropriate for a patient who has a new onset of chest pain?

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