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1. A nurse calls a physician in regard to a new medication order because the dosage prescribed is higher than the recommended dosage. The nurse is unable to locate the physician and the medication is due to be administered. Which of the following actions would the nurse take?
A. hold the medication until the physician can be contacted
B. administer the dosage prescribed
C. administer the recommended dose until the physician can be located
D. contact the nurse supervisor
2. A registered nurse arrives at work and is told to "float" to the ICU for the day because the ICU is understaffed and needs an additional nurse to care for the clients. The nurse has never worked in the ICU. Which of the following is the most appropriate nursing action?
A. refuse to float in the ICU
B. call the hospital lawyer
C. call the nursing supervisor
D. report to the ICU and identify tasks that can be safely performed
3. An 87 year-old female is brought to the emergency room for treatment of a fractured arm. On physical assessment, a nurse notes old and new ecchymotic areas on the client's chest and legs. The nurse asks the client how the bruises were sustained. The client although reluctant, tells the nurse in confidence that her son frequently hit her if supper is not ready on time when he arrives home from work. Which of the following is the most appropriate nursing response?
A. "Oh really, I will discuss the situation with your son."
B. "Do you have any friends who can help you out until you resolve these important issues with your son?"
C. "Lets talk about the ways you can manage your time to prevent this from happening."
D. "This is a legal issue, and I need to let you know that I will need to report."
4. A client is brought to the emergency room by the EMS after being hit by a car. The name of the client is not known. The client has sustained severe head injury and multiple fractures and is unconscious. An emergency craniotomy is required. In regard to informed consent for the surgical procedures, which of the following is the best initial nursing action?
A. call the police to identify the client and locate the family
B. obtain court order for the surgical procedure
C. ask the EMS team to sign the informed consent
D. transport the victim to the OR surgery
5. A nurse who works on the night shift enters the medication room and finds a co-worker with a tourniquet wrapped around the upper arm. The co-worker is about to insert a needle, attached to a syringe containing a clear liquid, into the antecubital area. The most appropriate initial action by the nurse is which of the following?
A. call the police
B. call security
C. lock the co-worker in the medication room until help is obtained
D. call the nursing supervisor
6. A nurse hears a client calling for help. The nurse hurries down the hallway to the client's room and found a client lying on the floor. The nurse performs a thorough assessment and assists the client back to bed. The nurse notifies the physician of the incident and completes an incident report. Which of the following would the nurse document on the incident report?
A. the client was found on the floor
B. the client climbed of the side rails
C. the client fell out of bed
D. the client became restless and tried to get out of bed
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