NCLEX 10000 Management of Care

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A client with acute kidney failure is placed on fluid restriction of 1000 mL of fluid over a 24-hour period. What is the priority nursing action?

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A client with acute kidney failure is placed on fluid restriction of 1000 mL of fluid over a 24-hour period. What is the priority nursing action?

Offer the client proportioned fluids in the day and less during the night.
Explanation:
The client and nurse should make a fluid schedule that takes into consideration factors such as periods of wakefulness, number of meals, oral medications, and personal preferences. Avoiding night fluids will decrease risk for aspiration.

While giving report to the oncoming night shift, the charge nurse smells alcohol on the breath of one of the nurses. The charge nurse should:

Report this to the nursing supervisor immediately
Explanation:
This situation should be reported immediately to the nursing supervisor or manager at the time. The nurse is liable to report a suspicious situation that could create an unsafe situation for the clients. Reporting a suspicious situation does not imply actual guilt; it implies identification of a high-risk situation. The supervisor will then follow the correct procedure for management and follow-up of the situation.

The nurse is caring for an adolescent with cancer who is well informed about the medical condition and treatment. The adolescent refused the morning medications and states intentions of refusing all future medications. What is the best action by the nurse?

Document the adolescent's choice and offer to discuss feelings about the medication.
Explanation:
The client has the right to choose whether to take the medication. The nurse should try to determine the reason for the adolescent not wanting the medication other than choice (e.g., side effects, fear of falling asleep and not waking).

A nurse who is a case manager is responsible for assigning client care to unregulated care providers (UCPs). The nurse is planning the care for a new client who requires several treatments. Which of the following UCPs should the nurse assign to the new client?

The UCP with the appropriate knowledge and skills to provide the care
Explanation:
The nurse is accountable for the assignment of tasks to UCPs. The nurse must ensure that the care being assigned is consistent with the UCP's level of knowledge, skill, and judgment. Assignments must also consider the UCP job description, agency policy, legislation, and client need.

A nurse is working within the managed care delivery model. Which of the following is true regarding managed care?

All systems reflect the values of efficiency and effectiveness.
Explanation:
All systems in the managed care delivery model reflect the values of efficiency and effectiveness. Different plans may have different values underlying the delivery of care. However, they all reflect the business plan values of efficiency and effectiveness.