Nurse Practitioner owned home health agency needs RNs for all west LA areas like West Hollywood, Beverly Hills, Westwood, Pacific Palisades and Santa Monica.
Supplement your income working when you want to make home visits.
IV and/or wound experience a huge plus.
Call 310 395 4788 to get started.
LVN & RN Jobs In Los Angeles
Available openings for both full time and per diem RN and LVN staff and supervisory positions within our newly established agency.
RNs
Seeking organized, experienced licensed Registered Nurses with strong planning and evaluation skills. Candidate will be required to complete initial assessments of patients and their families to determine home care needs, initiate the plan of care incorporating therapeutic, preventive and rehabilitative nursing actions.
Responsibilities
• Completion of physical assessments and illness histories with the patient and their family, then utilize this data to determine nursing diagnoses and develop a plan of care.
• Initiate appropriate preventive and rehabilitative nursing procedures and administer medication and treatments as prescribed by the physician.
• Counsel the patient and their family in meeting their needs and provide health care instructions per assessment and plan of care.
• Prepare clinical notes in a timely fashion and report any changes in condition to physician and obtain and receive orders as required.
• Ensure arrangements for equipment and services are made and follow through on receipt.
Requirements
• Bachelor’s Degree in Nursing preferred
• Bilingual a plus
• Current CA Licensure as an RN, CPR certification and a valid driver’s license
• Excellent observation, written and verbal communication skills, and problem solving abilities
• Must be able to pass a skills assessment per a nursing competency checklist
• Minimum 2 years experience in home health care; 1 year supervisory experience a plus
• Proficient in nursing and home care methodologies and best practices
LVNs
Seeking organized, experienced Licensed Vocational Nurses with strong treatment, reporting and documentation skills. Candidate will be required to implement the plan of care as assigned by the RN, and participate in the coordination of home health services.
Responsibilities
• Provide clinical support under the supervision of the RN.
• Implements plan of care initiated by the RN.
• Provides accurate and timely documentation consistent with the plan of care.
• Educate patients and their families on health related issues pertinent to diagnosis and plan of care.
• Assists in the treatment, program planning and implementation, related documentation and communication in conjunction with the RN.
Requirements
• Graduate of an accredited vocational nursing program
• Bilingual a plus
• Current CA Licensure as an LVN, CPR certification and a valid driver’s license
• Excellent observation, written and verbal communication skills, and problem solving abilities
• Must be able to pass a skills assessment per a nursing competency checklist
• Minimum 1 year experience in home health care
Please send your resume with salary requirements to:
Email: humanresources@comprehensivecenter.com
Fax: 310-734-0415
RNs
Seeking organized, experienced licensed Registered Nurses with strong planning and evaluation skills. Candidate will be required to complete initial assessments of patients and their families to determine home care needs, initiate the plan of care incorporating therapeutic, preventive and rehabilitative nursing actions.
Responsibilities
• Completion of physical assessments and illness histories with the patient and their family, then utilize this data to determine nursing diagnoses and develop a plan of care.
• Initiate appropriate preventive and rehabilitative nursing procedures and administer medication and treatments as prescribed by the physician.
• Counsel the patient and their family in meeting their needs and provide health care instructions per assessment and plan of care.
• Prepare clinical notes in a timely fashion and report any changes in condition to physician and obtain and receive orders as required.
• Ensure arrangements for equipment and services are made and follow through on receipt.
Requirements
• Bachelor’s Degree in Nursing preferred
• Bilingual a plus
• Current CA Licensure as an RN, CPR certification and a valid driver’s license
• Excellent observation, written and verbal communication skills, and problem solving abilities
• Must be able to pass a skills assessment per a nursing competency checklist
• Minimum 2 years experience in home health care; 1 year supervisory experience a plus
• Proficient in nursing and home care methodologies and best practices
LVNs
Seeking organized, experienced Licensed Vocational Nurses with strong treatment, reporting and documentation skills. Candidate will be required to implement the plan of care as assigned by the RN, and participate in the coordination of home health services.
Responsibilities
• Provide clinical support under the supervision of the RN.
• Implements plan of care initiated by the RN.
• Provides accurate and timely documentation consistent with the plan of care.
• Educate patients and their families on health related issues pertinent to diagnosis and plan of care.
• Assists in the treatment, program planning and implementation, related documentation and communication in conjunction with the RN.
Requirements
• Graduate of an accredited vocational nursing program
• Bilingual a plus
• Current CA Licensure as an LVN, CPR certification and a valid driver’s license
• Excellent observation, written and verbal communication skills, and problem solving abilities
• Must be able to pass a skills assessment per a nursing competency checklist
• Minimum 1 year experience in home health care
Please send your resume with salary requirements to:
Email: humanresources@comprehensivecenter.com
Fax: 310-734-0415
Seeking Certified Medical Assistant
Seeking full time Certified Medical Assistant urgently needed for Front and Back office in Mid-Wilshire area. With minimum requirements of 2 years experience. Must have excellent communication skills (oral and written), very personable, detail oriented and availability must include Saturdays and holidays.
Please fax resumes to (323)964-1457.
Please fax resumes to (323)964-1457.
Looking For Urgent Care Supervisor LVN (LAX area)
A Busy 24 Hour Urgent Care Clinic near the LAX is looking for License Vocational Nurses (LVN) with strong management experience to supervise staff and admissions.
Must have excellent communication / customer service skills, will be able to manage staff, schedules, and quality control measures.
Qualifications include:
- Minimum 2 years supervising employees
- Licensed LVN
- Urgent Care / Occupational Health experience a plus
Please email resume to ghowell@laxclinic.ne
Must have excellent communication / customer service skills, will be able to manage staff, schedules, and quality control measures.
Qualifications include:
- Minimum 2 years supervising employees
- Licensed LVN
- Urgent Care / Occupational Health experience a plus
Please email resume to ghowell@laxclinic.ne
Looking For Live-In or Live out Caregivers
Home helpers are looking Live-in,Live out or full time or part time caregivers who will provide non-medical care and companionship in-home to the elderly.
To Apply visit www.homehelpers.cc for more information or Call 805 506-9933.These are for Agoura, Westlake Village and Malibu work locations.
To Apply visit www.homehelpers.cc for more information or Call 805 506-9933.These are for Agoura, Westlake Village and Malibu work locations.
Lesion Assesment Mnemonics
Remember the Mnemonics : "ABCDE" in evaluating or assessing a lesion
Asymmetry
Border
Color and
Configuration
Diameter and
Drainage
Evolution or progression of the lesion
Asymmetry
Border
Color and
Configuration
Diameter and
Drainage
Evolution or progression of the lesion
Contact Precautions
In addition to Standard Precautions, Special Organisms Precautions are initiated and maintained to interrupt the transmission of epidemiologically significant microorganisms known to be spread by contact. These precautions are intended to reduce the colony count of bacteria on horizontal surfaces and in the immediate vicinity of the patient.
Special Organism Precautions (SOP) will be instituted on a case-by-case basis at the discretion of the Infection Control staff, Infectious Disease staff and/or Medical or Nursing staff. Instances in which special organism precautions apply are as follows:
• When a patient is colonized and/or infected with multiple drug-resistant organisms, or organisms that are not treatable with the usual antibiotics, i.e., vancomycin-resistant enterococcus (VRE), multi-drug resistant gram-negative rods, etc.
• When a particular organism is identified as being potentially hazardous because of its pathogenicity, virulence, or epidemiologic characteristics. e.g. rotavirus, Salmonella sp., Shigella sp . etc.
• For other organisms, these procedures may be instituted or modified at the discretion of IC staff (e.g. smallpox/vaccinia, Severe Acute Respiratory Syndrome (SARS).
I. POLICY for patients with diseases requiring ONLY the institution of Special
Organism Precautions/Contact Precautions. NOTE: Infection Control will
be notified by phone by Microbiology when a specimen is positive for VRE
or rotavirus. The Microbiology Lab will screen for vancomycin resistance in
enterococcus isolates from in-patients and selected out-patient services.
A. HANDWASHING
Handwashing for at least 10 seconds with an antimicrobial soap, or
alcohol gel use is required:
1. Between patient contacts
2. Following removal of gloves/other protective equipment in the
room.
3. Patients should be instructed in handwashing and the need for
precautions.
B. PERSONAL PROTECTIVE EQUIPMENT
1. Wear gloves for all contact with the patient, the patient's bedside
equipment, and the patient's environment.
a. Change gloves between distinctive tasks (e.g. wound care, perineal
care, suctioning).
b. Gloves must always be removed before leaving the room.
2. Wear a disposable gown for direct contact with the patient or the
environment if the patient is incontinent, or has diarrhea or a
draining wound.
a. Gowns may be worn one time only, then disposed of in the
regular (non-biohazardous) waste.
b. Cloth gowns may be substituted if there is no risk of splash
3. As per Standard Precautions, wear a mask and protective eyewear
when performing procedures that generate aerosols (Standard
Precautions)
C. PATIENT PLACEMENT
1. Place the patient in a private room.
2. Post "Special Organism Precaution" Stop sign on or next
to the door of the patient's room. The name of the infecting organism
may NOT be written on the sign.
3. A negative air pressure room is not required. The door may remain
open.
4. Patients who are currently on isolation precautions for any infection
may not be admitted to the Comfort Care Suites. Any questions
regarding this policy may be addressed to the Department of Hospital
Epidemiology and Infection Control.
5. It is not necessary to place patients on Special Organism Precautions
in a private room while they receive hemodialysis in the Acute
Hemodialysis Unit (AHU). A Special Organism Precautions isolation
sign should be placed at the foot of the patient's bed. Staff should
adhere to all other practices outlined in this policy including
appropriate use of barriers and task oriented use of gloves.
D. ENVIRONMENT
1. Provide the patient with his or her own equipment. The
equipment should not be shared (unless it is disinfected properly)
between patients. Examples include but are not limited to electronic
thermometer, blood pressure cuff, manometer, stethoscope, IV pole,
wheelchair, or gurney. For pediatric patients with stool-borne
pathogens (e.g. VRE, rotavirus, etc.) that require diaper weighing for
I & O measurement, a dedicated scale in the room is required.
2. Nursing staff should use an EPA-APPROVED DETERGENT/
DISINFECTANT to wipe down high touch surfaces once a day.
At a minimum, this cleaning should include bed rails, over bed table,
night stand, as well as the surfaces of electronic equipment,
respiratory therapy equipment, and other items that come in physical
contact with the patient. In critical care units, or units where there is
a high endemic rate of the organism, the wipe down should be
repeated each shift.
3. Quaternary Ammonium Compound (e.g. A456N or 3M Quat) is
currently available for the purposes of disinfection. Cleaning cloths
used in the room should not be used to lean other patients' rooms
and equipment. They should be laundered before reuse or discarded.
4. When the known VRE patient is transferred, please send signage,
supplies and patient dedicated equipment with the patient.
5. Upon discharge the room will be cleaned in accordance with the
PSA Cleaning Procedure. Cupboard supplies that have not been
opened and are intact may be left in the room for future use.
6. Waste disposal, spill management, linen and food trays are handled
in the same way for all patients, regardless of precaution category.
Isolation trays are not required. After patient use, both linen and food
trays are sent directly for cleaning and disinfection.
E. PATIENT TRANSPORT/AMBULATION
1. Nursing will notify Receiving Departments of any patients on
Special Organism Precautions.
2. Patients may walk in hall wearing a clean cover gown if they have
been instructed in handwashing, are continent, and able to cooperate
with procedures.
a. Diapered patients must be supervised when out of the room.
b. Pediatric patients may go to the playroom, the teen room and the
schoolroom with Infection Control/Child Life approval.
3. For patient transport, the following guidelines apply :
a. Wear gloves only if you are physically moving the patient from
the bed or gurney. Wear gloves and a gown only if the patient
is incontinent, or has diarrhea or a draining wound.
b. You must remove the gown and gloves in the room, wash your
hands, and then bring the patient to the receiving unit.
c. After transportation is complete, the gurney or wheelchair must be
wiped with a disinfectant.
4. For staff of procedure/diagnostic areas and practices, the
following guidelines apply:
a. Handwashing for at least 10 seconds with an antimicrobial soap,
or alcohol gel use is required:
1. Between patient contacts,
2. Following removal of gloves/other protective equipment in the
room.
.
b. Personal Protective Equipment
1. Wear gloves for all contact with the patient, the patient's
bedside equipment, and the patient's environment. Change
gloves between distinctive tasks (for example, wound care,
perineal care,suctioning). Gloves must always be removed
before leaving the room.
2. In the patient setting, wear a disposable gown for direct
contact with the patient, if the patient is incontinent, or has
diarrhea or a draining wound.
a. Gowns may be worn one time only, then disposed of in the
regular (non-biohazardous) waste.
b. Cloth gowns may be substituted if there is no risk of splash.
c. As per Standard Precautions, wear a mask and protective
eyewear when performing procedures that generate aerosols
3. Provide the patient with his or her own equipment.
The equipment should not be shared (unless it is
disinfected properly) between patients. Examples include
but are not limited to electronic thermometer, blood
pressure cuff, manometer, stethoscope, IV pole,
wheelchair, or gurney.
4. Staff should use an EPA-APPROVED DETERGENT/
DISINFECTANT to wipe down potentially contaminated
equipment that has been in direct contact with the
patient.
5. Quaternary Ammonium Compound such as A456N, or a
premixed agent such as Cavacide iscurrently available for the
purposes of disinfection. Cleaning cloths used in the room
should not be used to clean other patients' rooms and
equipment.
F. VISITORS/STAFF
1. Traffic should be limited to only essential staff/visitors.
2. All visitors shall be instructed in proper handwashing technique.
Visitors that participate in direct patient care shall be instructed in
gowning and gloving, if the patient is incontinent, diapered, or
has diarrhea or a draining wound.
3. Visitors may be referred to Infection Control or given written
educational material.
G. PATIENT TRANSFER/DISCHARGE
1. For patients being transferred to another facility, Infection Control,
discharge planner or physician shall notify the receiving institution
whenever possible.
2. If requested by Admitting, Medical Records or floor personnel, a list
of patients on SOP will be provided by the Infection Control
Department.
H. DISCONTINUATION OF PRECAUTIONS FOR A PATIENT WITH A
HISTORY OF VRE
1. IC consultation must be obtained prior to VRE screening for the
purpose of discontinuing SOP.
2. The Screening Procedure is as follows:
a. Physician/Nurse/Microbiology staff will call IC department for
approval.
b. Obtain a culture from previous VRE (+) site. If this culture is (-)
proceed to the next step.
c. Obtain three perianal swabs, one week apart. Under certain
circumstances the usual one week interval between cultures may
be altered with IC approval.
d. Culture procedure:
1. Perianal area should be swabbed thoroughly using a dry sterile
swab.
2. Place swab in culture tube without media.
3. Write on requisition "Screen for VRE" and "Infection Control
approved".
e. When three, consecutive perianal swabs are negative, SOP may
be discontinued. Infection Control must be notified.
3. If all three perianal swabs cannot be obtained during the same
admission, the process can be continued in the outpatient setting or
during the patient's next admission. Results from the outpatient
setting or another facility must be documented and made available to
Infection Control.
I. READMISSION OF PATIENTS WITH A HISTORY OF VRE
1. Patients who have culture confirmed VRE will have a
"Alert" placed on their electronic hospital record by the
Infection Control Department. This alert will cause a text message
stating "SPECIAL ORGANISM PRECAUTIONS IF ADMITTED"
2. The person performing the admission procedure for a patient with
this alert should phone the charge nurse of the receiving unit to
relay the following information so that SOP will be initiated by floor
staff:
a. Patient Name
b. Patient medical record number
c. Patient is to be put on Special Organism Precautions upon arrival
on the unit.
3. Once a patient has successfully cleared a VRE infection/colonization
as demonstrated by the above screening procedure, the SOP
“alert” will be removed by Infection Control staff.
4. Quality control checks on the system will be performed periodically
by Infection Control.
II. POLICY: Special Organism Precautions are implemented in a MODIFIED
form for certain diseases transmitted via contact as well as other routes.
A. Patients with suspected or confirmed smallpox, or complications from
the smallpox vaccine (vaccinia) require Special Organism/Contact
Precautions AND Airborne/AFB isolation.
B. Patients with suspected or confirmed Severe Acute Respiratory
Syndrome (SARS) require Special Organism/Contact Precautions AND
Airborne/AFB isolation.
Special Organism Precautions (SOP) will be instituted on a case-by-case basis at the discretion of the Infection Control staff, Infectious Disease staff and/or Medical or Nursing staff. Instances in which special organism precautions apply are as follows:
• When a patient is colonized and/or infected with multiple drug-resistant organisms, or organisms that are not treatable with the usual antibiotics, i.e., vancomycin-resistant enterococcus (VRE), multi-drug resistant gram-negative rods, etc.
• When a particular organism is identified as being potentially hazardous because of its pathogenicity, virulence, or epidemiologic characteristics. e.g. rotavirus, Salmonella sp., Shigella sp . etc.
• For other organisms, these procedures may be instituted or modified at the discretion of IC staff (e.g. smallpox/vaccinia, Severe Acute Respiratory Syndrome (SARS).
I. POLICY for patients with diseases requiring ONLY the institution of Special
Organism Precautions/Contact Precautions. NOTE: Infection Control will
be notified by phone by Microbiology when a specimen is positive for VRE
or rotavirus. The Microbiology Lab will screen for vancomycin resistance in
enterococcus isolates from in-patients and selected out-patient services.
A. HANDWASHING
Handwashing for at least 10 seconds with an antimicrobial soap, or
alcohol gel use is required:
1. Between patient contacts
2. Following removal of gloves/other protective equipment in the
room.
3. Patients should be instructed in handwashing and the need for
precautions.
B. PERSONAL PROTECTIVE EQUIPMENT
1. Wear gloves for all contact with the patient, the patient's bedside
equipment, and the patient's environment.
a. Change gloves between distinctive tasks (e.g. wound care, perineal
care, suctioning).
b. Gloves must always be removed before leaving the room.
2. Wear a disposable gown for direct contact with the patient or the
environment if the patient is incontinent, or has diarrhea or a
draining wound.
a. Gowns may be worn one time only, then disposed of in the
regular (non-biohazardous) waste.
b. Cloth gowns may be substituted if there is no risk of splash
3. As per Standard Precautions, wear a mask and protective eyewear
when performing procedures that generate aerosols (Standard
Precautions)
C. PATIENT PLACEMENT
1. Place the patient in a private room.
2. Post "Special Organism Precaution" Stop sign on or next
to the door of the patient's room. The name of the infecting organism
may NOT be written on the sign.
3. A negative air pressure room is not required. The door may remain
open.
4. Patients who are currently on isolation precautions for any infection
may not be admitted to the Comfort Care Suites. Any questions
regarding this policy may be addressed to the Department of Hospital
Epidemiology and Infection Control.
5. It is not necessary to place patients on Special Organism Precautions
in a private room while they receive hemodialysis in the Acute
Hemodialysis Unit (AHU). A Special Organism Precautions isolation
sign should be placed at the foot of the patient's bed. Staff should
adhere to all other practices outlined in this policy including
appropriate use of barriers and task oriented use of gloves.
D. ENVIRONMENT
1. Provide the patient with his or her own equipment. The
equipment should not be shared (unless it is disinfected properly)
between patients. Examples include but are not limited to electronic
thermometer, blood pressure cuff, manometer, stethoscope, IV pole,
wheelchair, or gurney. For pediatric patients with stool-borne
pathogens (e.g. VRE, rotavirus, etc.) that require diaper weighing for
I & O measurement, a dedicated scale in the room is required.
2. Nursing staff should use an EPA-APPROVED DETERGENT/
DISINFECTANT to wipe down high touch surfaces once a day.
At a minimum, this cleaning should include bed rails, over bed table,
night stand, as well as the surfaces of electronic equipment,
respiratory therapy equipment, and other items that come in physical
contact with the patient. In critical care units, or units where there is
a high endemic rate of the organism, the wipe down should be
repeated each shift.
3. Quaternary Ammonium Compound (e.g. A456N or 3M Quat) is
currently available for the purposes of disinfection. Cleaning cloths
used in the room should not be used to lean other patients' rooms
and equipment. They should be laundered before reuse or discarded.
4. When the known VRE patient is transferred, please send signage,
supplies and patient dedicated equipment with the patient.
5. Upon discharge the room will be cleaned in accordance with the
PSA Cleaning Procedure. Cupboard supplies that have not been
opened and are intact may be left in the room for future use.
6. Waste disposal, spill management, linen and food trays are handled
in the same way for all patients, regardless of precaution category.
Isolation trays are not required. After patient use, both linen and food
trays are sent directly for cleaning and disinfection.
E. PATIENT TRANSPORT/AMBULATION
1. Nursing will notify Receiving Departments of any patients on
Special Organism Precautions.
2. Patients may walk in hall wearing a clean cover gown if they have
been instructed in handwashing, are continent, and able to cooperate
with procedures.
a. Diapered patients must be supervised when out of the room.
b. Pediatric patients may go to the playroom, the teen room and the
schoolroom with Infection Control/Child Life approval.
3. For patient transport, the following guidelines apply :
a. Wear gloves only if you are physically moving the patient from
the bed or gurney. Wear gloves and a gown only if the patient
is incontinent, or has diarrhea or a draining wound.
b. You must remove the gown and gloves in the room, wash your
hands, and then bring the patient to the receiving unit.
c. After transportation is complete, the gurney or wheelchair must be
wiped with a disinfectant.
4. For staff of procedure/diagnostic areas and practices, the
following guidelines apply:
a. Handwashing for at least 10 seconds with an antimicrobial soap,
or alcohol gel use is required:
1. Between patient contacts,
2. Following removal of gloves/other protective equipment in the
room.
.
b. Personal Protective Equipment
1. Wear gloves for all contact with the patient, the patient's
bedside equipment, and the patient's environment. Change
gloves between distinctive tasks (for example, wound care,
perineal care,suctioning). Gloves must always be removed
before leaving the room.
2. In the patient setting, wear a disposable gown for direct
contact with the patient, if the patient is incontinent, or has
diarrhea or a draining wound.
a. Gowns may be worn one time only, then disposed of in the
regular (non-biohazardous) waste.
b. Cloth gowns may be substituted if there is no risk of splash.
c. As per Standard Precautions, wear a mask and protective
eyewear when performing procedures that generate aerosols
3. Provide the patient with his or her own equipment.
The equipment should not be shared (unless it is
disinfected properly) between patients. Examples include
but are not limited to electronic thermometer, blood
pressure cuff, manometer, stethoscope, IV pole,
wheelchair, or gurney.
4. Staff should use an EPA-APPROVED DETERGENT/
DISINFECTANT to wipe down potentially contaminated
equipment that has been in direct contact with the
patient.
5. Quaternary Ammonium Compound such as A456N, or a
premixed agent such as Cavacide iscurrently available for the
purposes of disinfection. Cleaning cloths used in the room
should not be used to clean other patients' rooms and
equipment.
F. VISITORS/STAFF
1. Traffic should be limited to only essential staff/visitors.
2. All visitors shall be instructed in proper handwashing technique.
Visitors that participate in direct patient care shall be instructed in
gowning and gloving, if the patient is incontinent, diapered, or
has diarrhea or a draining wound.
3. Visitors may be referred to Infection Control or given written
educational material.
G. PATIENT TRANSFER/DISCHARGE
1. For patients being transferred to another facility, Infection Control,
discharge planner or physician shall notify the receiving institution
whenever possible.
2. If requested by Admitting, Medical Records or floor personnel, a list
of patients on SOP will be provided by the Infection Control
Department.
H. DISCONTINUATION OF PRECAUTIONS FOR A PATIENT WITH A
HISTORY OF VRE
1. IC consultation must be obtained prior to VRE screening for the
purpose of discontinuing SOP.
2. The Screening Procedure is as follows:
a. Physician/Nurse/Microbiology staff will call IC department for
approval.
b. Obtain a culture from previous VRE (+) site. If this culture is (-)
proceed to the next step.
c. Obtain three perianal swabs, one week apart. Under certain
circumstances the usual one week interval between cultures may
be altered with IC approval.
d. Culture procedure:
1. Perianal area should be swabbed thoroughly using a dry sterile
swab.
2. Place swab in culture tube without media.
3. Write on requisition "Screen for VRE" and "Infection Control
approved".
e. When three, consecutive perianal swabs are negative, SOP may
be discontinued. Infection Control must be notified.
3. If all three perianal swabs cannot be obtained during the same
admission, the process can be continued in the outpatient setting or
during the patient's next admission. Results from the outpatient
setting or another facility must be documented and made available to
Infection Control.
I. READMISSION OF PATIENTS WITH A HISTORY OF VRE
1. Patients who have culture confirmed VRE will have a
"Alert" placed on their electronic hospital record by the
Infection Control Department. This alert will cause a text message
stating "SPECIAL ORGANISM PRECAUTIONS IF ADMITTED"
2. The person performing the admission procedure for a patient with
this alert should phone the charge nurse of the receiving unit to
relay the following information so that SOP will be initiated by floor
staff:
a. Patient Name
b. Patient medical record number
c. Patient is to be put on Special Organism Precautions upon arrival
on the unit.
3. Once a patient has successfully cleared a VRE infection/colonization
as demonstrated by the above screening procedure, the SOP
“alert” will be removed by Infection Control staff.
4. Quality control checks on the system will be performed periodically
by Infection Control.
II. POLICY: Special Organism Precautions are implemented in a MODIFIED
form for certain diseases transmitted via contact as well as other routes.
A. Patients with suspected or confirmed smallpox, or complications from
the smallpox vaccine (vaccinia) require Special Organism/Contact
Precautions AND Airborne/AFB isolation.
B. Patients with suspected or confirmed Severe Acute Respiratory
Syndrome (SARS) require Special Organism/Contact Precautions AND
Airborne/AFB isolation.
Types of Coping Mechanisms
1. Compensation - extra effort in one area to offset real or imagined
lack in another area
Example: Short man becomes assertively verbal and excels in business.
2. Conversion - A mental conflict is expressed through physical symptoms
Example: Woman becomes blind after seeing her husband with another woman.
3. Denial - treating obvious reality factors as though they do not exist because
they are consciously intolerable
Example: Mother refuses to believe her child has been diagnosed with leukemia.
"She just has the flu."
4. Displacement - transferring unacceptable feelings aroused by one object
to another,more acceptable substitute
Example: Adolescent lashes out at parents after not being invited to party.
5. Dissociation - walling off specific areas of the personality from consciousness
Example: Adolescent talks about failing grades as if they belong to
someone else;jokes about them.
6. Fantasy - a conscious distortion of unconscious wishes and need to
obtain satisfaction
Example: A student nurse fails the critical care exam and daydreams about
her heroic role in a cardiac arrest.
7. Fixation - becoming stagnated in a level of emotional development in
which one is comfortable
Example: A sixty year old man who dresses and acts as if he were still
in the 1960's.
8. Identification - subconsciously attributing to oneself qualities of others
Example: Elvis impersonators.
9. Intellectualization - use of thinking, ideas, or intellect to avoid emotions
Example: Parent becomes extremely knowledgeable about child's diabetes.
10. Introjection - incorporating the traits of others
Example: Husband's symptoms mimic wife's before she died.
11. Projection - unconsciously projecting one's own unacceptable qualities
or feelings onto others
Example: Woman who is jealous of another woman's wealth accuses her
of being a gold-digger.
12. Rationalization - justifying behaviors, emotions, motives, considered
intolerable through acceptable excuses
Example: "I didn't get chosen for the team because the coach plays
favorites."
13. Reaction Formation - expressing unacceptable wishes or behavior by
opposite overt behavior
Example: Recovered smoker preaches about the dangers of second
hand smoke.
14. Regression - retreating to an earlier and more comfortable emotional
level of development
Example: Four year old insists on climbing into crib with younger sibling.
15. Repression - unconscious, deliberate forgetting of unacceptable or
painful thoughts,impulses, feelings or acts
Example: Adolescent "forgets" appointment with counselor to discuss
final grades.
16. Sublimation - diversion of unacceptable instinctual drives into personally
and socially acceptable areas.
Example: Young woman who hated school becomes a teacher.
lack in another area
Example: Short man becomes assertively verbal and excels in business.
2. Conversion - A mental conflict is expressed through physical symptoms
Example: Woman becomes blind after seeing her husband with another woman.
3. Denial - treating obvious reality factors as though they do not exist because
they are consciously intolerable
Example: Mother refuses to believe her child has been diagnosed with leukemia.
"She just has the flu."
4. Displacement - transferring unacceptable feelings aroused by one object
to another,more acceptable substitute
Example: Adolescent lashes out at parents after not being invited to party.
5. Dissociation - walling off specific areas of the personality from consciousness
Example: Adolescent talks about failing grades as if they belong to
someone else;jokes about them.
6. Fantasy - a conscious distortion of unconscious wishes and need to
obtain satisfaction
Example: A student nurse fails the critical care exam and daydreams about
her heroic role in a cardiac arrest.
7. Fixation - becoming stagnated in a level of emotional development in
which one is comfortable
Example: A sixty year old man who dresses and acts as if he were still
in the 1960's.
8. Identification - subconsciously attributing to oneself qualities of others
Example: Elvis impersonators.
9. Intellectualization - use of thinking, ideas, or intellect to avoid emotions
Example: Parent becomes extremely knowledgeable about child's diabetes.
10. Introjection - incorporating the traits of others
Example: Husband's symptoms mimic wife's before she died.
11. Projection - unconsciously projecting one's own unacceptable qualities
or feelings onto others
Example: Woman who is jealous of another woman's wealth accuses her
of being a gold-digger.
12. Rationalization - justifying behaviors, emotions, motives, considered
intolerable through acceptable excuses
Example: "I didn't get chosen for the team because the coach plays
favorites."
13. Reaction Formation - expressing unacceptable wishes or behavior by
opposite overt behavior
Example: Recovered smoker preaches about the dangers of second
hand smoke.
14. Regression - retreating to an earlier and more comfortable emotional
level of development
Example: Four year old insists on climbing into crib with younger sibling.
15. Repression - unconscious, deliberate forgetting of unacceptable or
painful thoughts,impulses, feelings or acts
Example: Adolescent "forgets" appointment with counselor to discuss
final grades.
16. Sublimation - diversion of unacceptable instinctual drives into personally
and socially acceptable areas.
Example: Young woman who hated school becomes a teacher.
Airborne Precautions Review
AIRBORNE/AFB PRECAUTIONS
(for M. tuberculosis and SARS (Severe Acute Respiratory Syndrome))
I. POLICY
In addition to Standard Precautions, Airborne/AFB Precautions are required
when a patient is suspected or known to have a disease transmitted by
airborne droplet nuclei. These evaporated droplets contain microorganisms
that remain suspended in the air and can be widely dispersed by air currents
within a room or over a long distance.
This category of precautions includes the following diseases or infections:
tuberculosis (TB), SARS (Severe Acute Respiratory Syndrome) smallpox
and complications from the smallpox vaccine (generalized vaccinia,
erythema mulitforme, progressive vaccinia or eczemavaccinatum) and
Hemorrhagic fevers (Ebola, Lassa, Marburg).
II. HANDWASHING
Strict handwashing after contact with patient or items contaminated with
respiratory secretions is required.
III. PERSONAL PROTECTIVE EQUIPMENT (PPE)
A. Follow Standard Precautions
B. Wear an OSHA approved mask for Tuberculosis, such as the N95
mask/respirator for which you have been fit-tested or PAPR.
C. For patients who require 24-hour in-room observation (e.g., psychiatric or
incarcerated patients), the in-room sitter must use a PAPR or a fit tested
N-95 respirator. If the in-room sitter has been fit tested, they should bring
their own N-95 respirator, or the unit will provide a PAPR.
IV. PATIENT PLACEMENT
A. Place patient in a private room with monitored negative air pressure in
relation to surrounding areas, with a minimum of six (6) air exchanges
per hour.
B. Air from the room must be discharged outdoors or monitored with high
efficiency filtration of room air before circulated to other areas in the
hospital.
1. Use a designated negative pressure room whenever possible.
2. Nursing will notify Management when
precautions are discontinued.
C. The door to the patient's room must remain closed except for entry/exit.
D. Windows must remain closed.
E. Post "AFB/Airborne Precaution" Stop sign on or next to the door
of the patient's room. DO NOT write "Tuberculosis" or "TB" on the sign.
F. Obtain the Respiratory Protection cart from Material Services for
placement outside the patient's room.
G. Patients who are currently on isolation precautions for any infection may
not be admitted to the Comfort Care Suites. Any question regarding this
policy may be addressed to the Department of Hospital Epidemiology
and Infection Control.
V. ENVIRONMENT
Waste disposal, spill management, linen and food trays are handled in the
same way for all patients, regardless of precaution category.
VI. PATIENT TRANSPORT/AMBULATION
A. The patient must be confined to his/her room unless a procedure is
necessary which must be performed at a location outside the room.
B. The receiving department must be notified of the patient's diagnosis.
C. The patient must wear a surgical mask outside of the room when
transported to another department.
D. Patients who are discharged from the hospital but still considered
contagious must be instructed in the need for wearing a surgical mask.
VII. VISITORS
A. Visitors will wear a surgical mask that is secured and snugly fitted.
B. Symptomatic household or other contacts of patient should not
visit until medically cleared. If symptomatic contact must visit, mask
will be donned before entering the hospital and worn continuously while
in the facility.
VIII. DISCONTINUATION OF PRECAUTIONS
The patient room is to be left vacant for one hour if the patient is considered to be infectious and was not covering cough.
NCLEX Review Apgar Scoring
Assess and document APGAR at 1 and 5 minutes
• Appearance
› Pink torso and extremities: Score = 2
› Pink torso, blue extremities: Score = 1
› Blue all over: Score = 0
• Pulse
› >100: Score = 2
› 100: Score = 1
› Absent: Score = 0
• Grimace (irritability)
› Vigorous cry: Score = 2
› Limited cry: Score = 1
› No response to stimulus: Score = 0
• Activity
› Actively moving: Score = 2
› Limited movement: Score = 1
› Flaccid: Score = 0
• Respiratory Effort
› Strong loud cry: Score = 2
› Hypoventilation, irregular: Score = 1
› Absent: Score = 0
Totals*
*8-10: normal; 4-6: moderate depression; 0-3: aggressive resuscitation
• Appearance
› Pink torso and extremities: Score = 2
› Pink torso, blue extremities: Score = 1
› Blue all over: Score = 0
• Pulse
› >100: Score = 2
› 100: Score = 1
› Absent: Score = 0
• Grimace (irritability)
› Vigorous cry: Score = 2
› Limited cry: Score = 1
› No response to stimulus: Score = 0
• Activity
› Actively moving: Score = 2
› Limited movement: Score = 1
› Flaccid: Score = 0
• Respiratory Effort
› Strong loud cry: Score = 2
› Hypoventilation, irregular: Score = 1
› Absent: Score = 0
Totals*
*8-10: normal; 4-6: moderate depression; 0-3: aggressive resuscitation
New CPR Guidelines and Procedures
Watch and learn the new CPR guidelines these are the standard ways in doing the rescue procedure. These are set by the American Heart Association. It is recommended that compressions should be 30 and 2 breaths for adults,infants and children (1 person rescue) and 15 compressions to 2 breaths (2 rescue persons) in infants and children.
Convalescent RN Needed
Looking for morning shift RNs in an established Convalescent Hospital in Glendale, California. New RNs are also welcome. Please send in your resumes via fax at (310) 644-5990 or email: jobs@isocare.com
Watch Grey's Anatomy Season 1-5 Episodes
Grey’s Anatomy revolves around Dr. Meredith Grey, played by Ellen Pompeo, a surgical intern at Seattle Grace Hospital in Seattle, Washington. The characters of the comedy and drama series include a group of surgical interns and the various physicians who serve as mentors to the interns in their professional and personal lives. Featuring a star studded casts that includes Sandra Oh as Dr. Cristina Yang, Katherine Heigl as Dr. Isobel “Izzie” Stevens, Justin Chambers as Dr. Alex Karev, T.R. Knight as Dr. George O’Malley, Patrick Dempsey as Dr. Derek Shepherd, Isaiah Washington as Dr. Preston Burke, and more.
Watch your favorite Grey's Anatomy show from Season 1 - 5 and click on here for the link
Watch your favorite Grey's Anatomy show from Season 1 - 5 and click on here for the link
RN Jobs In Santa Monica California
Functional Medicine Clinic located in Santa Monica looking for a great RN with a holistic view with at least 5 years of experience.
Must have:
Great positive attitude
able to work in a very busy environment
able to work with LASER (palomar)
gyn knowledge is a big plus (pap's, ultrasounds etc..)
able to do injectables (juvaderm)
correspond to patient questions via e-mail or phone.
visit www.thehallcenter.com
E-mail us your resume with your references at melissa@thehallcenter.com
Must have:
Great positive attitude
able to work in a very busy environment
able to work with LASER (palomar)
gyn knowledge is a big plus (pap's, ultrasounds etc..)
able to do injectables (juvaderm)
correspond to patient questions via e-mail or phone.
visit www.thehallcenter.com
E-mail us your resume with your references at melissa@thehallcenter.com
NCLEX-RN Review Crutch Walking
CRUTCH WALKING
A. Four-point sequence
1. Gait is slow but stable
2. Used when client can bear some weight on each leg
3. Technique
a. Move right crutch
b. Move left foot
c. Move left crutch
d. Move right foot
B. Three-point sequence
1. Client cannot bear any weight on one leg
2. The crutches completely support the affected leg
3. Technique
a. Move both crutches with the affected leg forward
b. Move unaffected leg forward
4. Use of mechanical aids to promote mobility
a. Crutches-support; balance feet, and legs during walking
A. keep tips of crutches 12 to 16 inches to side of feet
B. adjust handbars to allow 15 to 30 degrees of elbow flexion
C. use well fitting shoes with nonslip soles
D. use rubber suction tips on crutches
a. inspect weekly
b. replace when worn
E. may be used temporarily or permanently
F. teach client crutch walking
G. Cane-provides stability when walking and relieves pressure on weight-bearing joints
a. adjust cane with handle at level of greater trochanter, elbow flexed at 30 degree angle
b. teach client to hold cane close to body, and hold in hand on stronger side.
c. move cane at same time as the weaker leg.
d. Walker-assists in weight bearing and mobility
A. assists in weight bearing and mobility
B. teach client how to sit, stand and turn
C. Gait belt
a. leather or canvas belt around client's waist with handles
b. safety devices for ambulatory clients who may have some balance problems
5. Prosthetic devices - used to replace a missing body part
6. Brace - support for weakened muscles
A. Four-point sequence
1. Gait is slow but stable
2. Used when client can bear some weight on each leg
3. Technique
a. Move right crutch
b. Move left foot
c. Move left crutch
d. Move right foot
B. Three-point sequence
1. Client cannot bear any weight on one leg
2. The crutches completely support the affected leg
3. Technique
a. Move both crutches with the affected leg forward
b. Move unaffected leg forward
4. Use of mechanical aids to promote mobility
a. Crutches-support; balance feet, and legs during walking
A. keep tips of crutches 12 to 16 inches to side of feet
B. adjust handbars to allow 15 to 30 degrees of elbow flexion
C. use well fitting shoes with nonslip soles
D. use rubber suction tips on crutches
a. inspect weekly
b. replace when worn
E. may be used temporarily or permanently
F. teach client crutch walking
G. Cane-provides stability when walking and relieves pressure on weight-bearing joints
a. adjust cane with handle at level of greater trochanter, elbow flexed at 30 degree angle
b. teach client to hold cane close to body, and hold in hand on stronger side.
c. move cane at same time as the weaker leg.
d. Walker-assists in weight bearing and mobility
A. assists in weight bearing and mobility
B. teach client how to sit, stand and turn
C. Gait belt
a. leather or canvas belt around client's waist with handles
b. safety devices for ambulatory clients who may have some balance problems
5. Prosthetic devices - used to replace a missing body part
6. Brace - support for weakened muscles
CNA Job In Tujunga California
Looking for an experienced CNA (Certified Nursing Assistant) to work for an elderly woman with dementia.
Location: Tijunga, California
Days and Hours: M-F from 2:00 pm to 6:00 pm and Sat & Sun for 4 hours each day.
Job Requirements include:
-Excellent Job References -Clean Background (we verify)
-Reliable Transportation -80% Pass Rate on Competency Exam
-Valid CNA Certificate/License -Speak & Write Fluent English
-Ability to Make Accurate Chart Notes (legibly, and correct spelling a must!)
-Possess Desire to Help our Clients -Be Dependable
Call Debbie at 626-584-8131 to set up an appointment or visit www.pasadena.rightathome.net
Location: Tijunga, California
Days and Hours: M-F from 2:00 pm to 6:00 pm and Sat & Sun for 4 hours each day.
Job Requirements include:
-Excellent Job References -Clean Background (we verify)
-Reliable Transportation -80% Pass Rate on Competency Exam
-Valid CNA Certificate/License -Speak & Write Fluent English
-Ability to Make Accurate Chart Notes (legibly, and correct spelling a must!)
-Possess Desire to Help our Clients -Be Dependable
Call Debbie at 626-584-8131 to set up an appointment or visit www.pasadena.rightathome.net
NCLEX Review Positive Signs of Brain Death
Positive signs of brain death or brain damage
+Unresponsiveness to all stimuli
+Pupillary responses are absent
+All brain functions cease
+No eye movements are noted when cold water is instilled into the ears (caloric test).
+No corneal reflex is present
+No gag reflex is present
+Quick rotation of the patient's head from left to right (doll's eyes test) causes the eyes to remain fixed, suggesting brain death.
+No response to painful stimuli is present
+An apnea test reveals no spontaneous breathing
+EEG shows no brain activity or response
+Unresponsiveness to all stimuli
+Pupillary responses are absent
+All brain functions cease
+No eye movements are noted when cold water is instilled into the ears (caloric test).
+No corneal reflex is present
+No gag reflex is present
+Quick rotation of the patient's head from left to right (doll's eyes test) causes the eyes to remain fixed, suggesting brain death.
+No response to painful stimuli is present
+An apnea test reveals no spontaneous breathing
+EEG shows no brain activity or response
Nursing Delagation Questions For NCLEX-RN
Question 1
The measurement and documentation of vital signs is expected for clients in a long term facility. Which staff type would it be a priority to delegate these tasks to?
A) Practical nurse (PN)
B) Registered Nurse (RN)
C) Unlicensed assistive personnel (UAP)
D) Volunteer
Review Information: The correct answer is C: Unlicensed assistive personnel (UAP)
The measurement and recording of vital signs may be delegated to UAP. This falls under the umbrella of routine task with stable clients. Other considerations for delegation of care to UAP would be: Who is capable and is the least expensive worker to do each task?
Question 2
Which client data should the nurse act upon when a home health aide calls the nurse from the client's home to report these items?
A) "The client has complaints of not sleeping well for the past week"
B) "The family wants to discontinue the home meal service, meals on wheels"
C) "The urine in the urinary catheter bag is of a deeper amber, almost brown color"
D) "The partner says the client has slower days every other day"
Review Information: The correct answer is C: "The urine in the urinary catheter bag is of a deeper amber, almost brown color"
Home health aides need to report diverse information to nurses through phone calls and documentation. The nurse who develops the plan of care for a specific client, and supervises the aide, must identify potential danger signs which require immediate action and follow-up. The color of the urine requires follow-up evaluation.
Question 3
A 25 year-old client, unresponsive after a motor vehicle accident, is being transferred from the hospital to a long term care facility. To which staff member should the charge nurse assign the client?
A) Unlicensed assistive personnel (UAP)
B) Senior nursing student
C) PN
D) RN
Review Information: The correct answer is D: RN
The RN is responsible for teaching and assessment associated with discharge and these activities cannot be delegated to the others listed.
Question 4
A practical nurse (PN) from the pediatric unit is assigned to work in a critical care unit. Which client assignment would be appropriate?
A) A client admitted with multiple trauma with a history of a newly implanted pacemaker
B) A new admission with left-sided weakness from a stroke and mild confusion
C) A 53 year-old client diagnosed with cardiac arrest from a suspected myocardial infarction
D) A 35 year-old client in balanced traction admitted 6 days ago after a motor vehicle accident
Review Information: The correct answer is D: A 35 year-old client in balanced traction admitted 6 days ago after a motor vehicle accident
This client is the most stable with a predictable outcome.
Question 5
A client has had a tracheostomy for 2 weeks after a motor vehicle accident. Which task could the RN safely delegate to unlicensed assistive personnel (UAP)?
A) Teach the client how to cough up secretions
B) Changes the tracheostomy trach ties
C) Monitor if client has shortness of breath
D) Perform routine tracheostomy dressing care
Review Information: The correct answer is D: Perform routine tracheostomy dressing care
Unlicensed assistive personnel should be able to perform routine tracheostomy care.
Question 6
An unlicensed assistive personnel (UAP), who usually works in pediatrics is assigned to work on a medical-surgical unit. Which one of the questions by the charge nurse would be most appropriate prior to making delegation decisions?
A) "How long have you been a UAP?”
B) "What type of care did you give in pediatrics?”
C) "Do you have your competency checklist that we can review?”
D) "How comfortable are you to care for adult clients?”
Review Information: The correct answer is C: "Do you have your competency checklist that we can review?”
The UAP must be competent to accept the delegated task. Further assessment of the qualifications of the UAP is important in order to assign the right task.
Question 7
An RN from the women’s health clinic is temporarily reassigned to a medical-surgical unit. Which of these client assignments would be most appropriate for this nurse?
A) A newly diagnosed client with type 2 diabetes mellitus who is learning foot care
B) A client from a motor vehicle accident with an external fixation device on the leg
C) A client admitted for a barium swallow after a transient ischemic attack
D) A newly admitted client with a diagnosis of pancreatic cancer
Review Information: The correct answer is B: A client from a motor vehicle accident with an external fixation device on the leg
This client is the most stable, requires basic safety measures and has a predictable outcome.
Question 8
The RN delegates the task of taking vital signs of all the clients on the medical-surgical unit to an unlicensed assistive personnel (UAP). Specific written and verbal instructions are given to not take a post-mastectomy client’s blood pressure on the left arm. Later as the RN is making rounds, the nurse finds the blood pressure cuff on that client’s left arm. Which of these statements is most immediately accurate?
A) The RN has no accountability for this situation
B) The RN did not delegate appropriately
C) The UAP is covered by the RN’s license
D) The UAP is responsible for following instructions
Review Information: The correct answer is D: The UAP is responsible for following instructions
The UAP is responsible for carrying out the activity correctly once directions have been clearly communicated especially if given verbally and in writing.
Question 9
The nurse in a same-day surgery unit assigns the unlicensed assistive personnel (UAP) to provide a hernia patient with a lunch tray. Which statement by the nurse is most appropriate?
A) "Tell the family they can bring in a pizza if the patient would prefer that."
B) "Make sure the patient gets at least 2 cartons of milk."
C) "Stop the IV if the patient is able to eat solid food."
D) "Encourage the patient to eat slowly to prevent gas."
Review Information: The correct answer is D: "Encourage the patient to eat slowly to prevent gas."
The professional nurse can delegate tasks with an expected outcome. The UAP is given adequate information about the task and how to promote the best outcome.
Question 10
A staff nurse complains to the nurse manager that an unlicensed assistive personnel (UAP) consistently leaves the work area untidy and does not restock supplies. The best initial response by the nurse manager is which of these statements?
A) "I will arrange for a conference with you and the UAP within the next week"
B) "I can assure you that I will look into the matter"
C) "I would like for you to approach the UAP about the problem the next time it occurs"
D) I will add this concern to the agenda for the next unit meeting
Review Information: The correct answer is C: "I would like for you to approach the UAP about the problem the next time it occurs"
Helping staff manage conflict is part of the manager''s role. It is appropriate to urge the nurse to confront the other staff member to work out problems without a manager''s intervention when possible.
Question 11
The home care nurse has been managing a client for 6 weeks. What is the best method to determine the quality of care provided by a home health care aide assigned to assist with the care of this client?
A) Ask the client and family if they are satisfied with the care given
B) Determine if the home health aide's care is consistent with the plan of care
C) Investigate if the home health aide is prompt and stays an appropriate length of time for care
D) Check the documentation of the aide for appropriateness and comprehensiveness
Review Information: The correct answer is B: Determine if the home health aide''s care is consistent with the plan of care
Although the nurse must complete all of the above responsibilities, evaluation of an adherence to the plan of care is the first priority. The plan of care is based on the reason for referral, provider''s orders, the initial nursing assessment, the client’s responses to the planned interventions, and the client''s and family''s feedback or inquires. The other possible answers represent aspects of accomplishing “B”.
Question 12
The nurse assigns an unlicensed assistive personnel (UAP) to care for a client with a musculoskeletal disorder. The client ambulates with a leg splint. Which task requires supervision of the UAP?
A) Report signs of redness overlying a joint
B) Monitor the client's response to ambulatory activity
C) Encouragement for the independence in self-care
D) Assist the client to transfer from a bed to a chair
Review Information: The correct answer is B: Monitor the client''s response to ambulatory activity
Monitoring the client’s response to interventions requires assessment, a task to be performed by an RN.
Question 13
The care of which of the following clients can the nurse safely delegate to an unlicensed assistive personnel (UAP)?
A) A client with peripheral vascular disease and an ulceration of the lower leg.
B) A pre-operative client awaiting adrenalectomy with a history of asthma
C) An elderly client with hypertension and self-reported non-compliance
D) A new admission with a history of transient ischemic attacks and dizziness
Review Information: The correct answer is A: A client with peripheral vascular disease and an ulceration of the lower leg.
This client is stable with no risk of instability as compared to the other clients. And this client has a chronic condition, needs supportive care.
Question 14
A charge nurse working in a long term care facility is making out assignments. Which assignment made by a registered nurse to an unlicensed assistive personnel (UAP) requires intervention by the supervisor?
A) Provide decubitus ulcer care and apply a dry dressing
B) Bathe and feed a client on bed rest
C) Oral suctioning of an unresponsive elderly client
D) Teaching a family intermittent (bolus) feedings via G-tube before discharge
Review Information: The correct answer is D: Teaching a family intermittent (bolus) feedings via G-tube before discharge. Initial teaching can not be delegated to a UAP or a PN and must be done by RNs.
Question 15
As the RN responsible for a client in isolation, which can be delegated to the practical nurse (PN)?
A) Reinforcement of isolation precautions
B) Assessment of the client's attitude about infection control
C) Evaluation of staffs' compliance with control measures
D) Observation of the client's total environment for risks
Review Information: The correct answer is A: Reinforcement of isolation precautions
PNs and UAPs can reinforce information that was originally given by the RN.
Question 16
When walking past a client’s room, the nurse hears 1 unlicensed assistive personnel (UAP) talking to another UAP. Which statement requires follow-up intervention?
A) "If we work together we can get all of the client care completed."
B) "Since I am late for lunch, would you do this one client's glucose test?"
C) "This client seems confused, we need to watch monitor closely."
D) "I’ll come back and make the bed after I go to the lab."
Review Information: The correct answer is B: "Since I am late for lunch, would you do this one client''s glucose test?"
Only the RN and PN can delegate to UAPs. One UAP can not delegate a task to another UAP. The RN or PN is legally accountable for the nursing care.
Question 17
Which of these clients would be appropriate to assign to a practical nurse (PN)?
A) A trauma victim with multiple lacerations and requires complex dressings
B) An elderly client with cystitis and an indwelling urethral catheter
C) A confused client whose family complains about the nursing care 2 days after surgery
D) A client admitted for possible transient ischemic attack with unstable neurological signs
Review Information: The correct answer is B: An elderly client with cystitis and an indwelling urethral catheter
This is a stable client, with predictable outcome and care and minimal risk for complications.
Question 18
Which of these clients would be most appropriate to assign to a practical nurse (PN)?
A) A trauma victim with quadriplegia and a client 1 day post-op radical neck dissection
B) A client with newly diagnosed type 2 diabetes mellitus and a client with a history of AIDS admitted for pneumonia
C) A client with hemiplegia is fed by a nasogastric tube and client with a left leg amputation in rehabilitation
D) A client with a history of schizophrenia in alcohol withdrawal and a client with chronic renal failure
Review Information: The correct answer is C: A client with hemiplegia is fed by a nasogastric tube and client with a left leg amputation in rehabilitation
This client requires supportive care and interventions within the scope of practice of a PN. This client is stable with little risk of complications or instability.
Question 19
The charge nurse on a cardiac step-down unit makes assignments for the team consisting of a registered nurse (RN), a practical nurse (PN), and an unlicensed assistive personnel (UAP). Which client should be assigned to the PN?
A) A 49 year-old with new onset atrial fibrillation with a rapid ventricular response
B) A 58 year-old hypertensive with possible angina
C) A 35 year-old scheduled for cardiac catheterization
D) A 65 year-old for discharge after angioplasty and stent placement
Review Information: The correct answer is B: A 58 year-old hypertensive with possible angina
This is the most stable client. The clients in options C and D require initial teaching. The client in option A is considered unstable since the dysrhythmia is a new onset.
Question 20
Which task for a client with anemia and confusion could the nurse delegate to the unlicensed assistive personnel (UAP)?
A) Assess and document skin turgor and color changes
B) Test stool for occult blood and urine for glucose and report results
C) Suggest foods high in iron and those easily consumed
D) Report mental status changes and the degree of mental clarity
Review Information: The correct answer is B: Test stool for occult blood and urine for glucose and report results
The UAP can do standard, unchanging procedures that require no decision making.
Question 21
During the interview of a prospective employee who just completed the agency orientation, which approach would be the best for the nurse manager to use to assess competence?
A) "What degree of supervision for basic care do you think you need?"
B) "Let’s review your skills check-list for type and level of skill"
C) "Are you comfortable working independently?"
D) "What client care tasks or assignments do you prefer?"
Review Information: The correct answer is B: "Let’s review your skills check-list for type and level of skill"
The nurse needs to know that the employee has competence in certain tasks. One way to do this is to do mutual review of documented skills.
Question 22
A client is receiving an intravenous (IV) infusion for pain control. When caring for this client, which one of these actions can the RN safely assign to an unlicensed assistive personnel (UAP)?
A) Ask the client the degree of relief and document the client’s response
B) Decrease the set rate on the pump by 2 ml/minute
C) Check the IV site for drainage and loose tape
D) Assist the client with ambulation and a gown change with supervision
Review Information: The correct answer is D: Assist the client with ambulation and a gown change with supervision
When directing the UAP, communicate clearly and specifically what the task is and what should be reported to the nurse. Implementation of routine tasks should be delegated since they do not require independent judgment.
Question 23
Which one of these tasks can be safely delegated to a practical nurse (PN)?
A) Assess the function of a newly created ileostomy
B) Care for a client with a recent complicated double barrel colostomy
C) Provide stoma care for a client with a well functioning ostomy
D) Teach ostomy care to a client and their family members
Review Information: The correct answer is C: Provide stoma care for a client with a well functioning ostomy
The care of a mature stoma and the application of an ostomy appliance may be delegated to a PN. This client has minimal risk of instability of the situation.
Question 24
Which statement by the nurse is appropriate when giving an assignment to an unlicensed assistive personnel (UAP) to help a client ambulate for the first time after a colon resection?
A) "Have the client sit on the side of the bed before helping the client to walk."
B) "If the client is dizzy ask the client to take some slow, deep breaths."
C) "Help the client to walk in the room as often as the client wishes."
D) "When you help the client to walk, ask if any pain occurs."
Review Information: The correct answer is A: "Have the client sit on the side of the bed before helping the client to walk."
This statement gives clear directions to the UAP about the task and is most closely associated with the information provided in the stem that this is the client''s first time out of bed after surgery.
Question 25
Two people call in sick on the medical-surgical unit and no additional help is available. The team consists of an RN, an LPN and an unlicensed assistive personnel (UAP). Which of these activities should the nurse assign to the UAP?
A) Assist with plans for any clients discharged
B) Provide basic hygiene care to all clients on the unit
C) Assess a client after an acute myocardial infarction
D) Gather the vital signs of all clients on the unit
Review Information: The correct answer is B: Provide basic hygiene care to all clients on the unit
Basic client care, which is routine, should be delegated to a UAP since the unit is short on help. The vital signs can be done by the RN and PN as they make rounds since this data is more critical to making decisions about the care of the clients.
The measurement and documentation of vital signs is expected for clients in a long term facility. Which staff type would it be a priority to delegate these tasks to?
A) Practical nurse (PN)
B) Registered Nurse (RN)
C) Unlicensed assistive personnel (UAP)
D) Volunteer
Review Information: The correct answer is C: Unlicensed assistive personnel (UAP)
The measurement and recording of vital signs may be delegated to UAP. This falls under the umbrella of routine task with stable clients. Other considerations for delegation of care to UAP would be: Who is capable and is the least expensive worker to do each task?
Question 2
Which client data should the nurse act upon when a home health aide calls the nurse from the client's home to report these items?
A) "The client has complaints of not sleeping well for the past week"
B) "The family wants to discontinue the home meal service, meals on wheels"
C) "The urine in the urinary catheter bag is of a deeper amber, almost brown color"
D) "The partner says the client has slower days every other day"
Review Information: The correct answer is C: "The urine in the urinary catheter bag is of a deeper amber, almost brown color"
Home health aides need to report diverse information to nurses through phone calls and documentation. The nurse who develops the plan of care for a specific client, and supervises the aide, must identify potential danger signs which require immediate action and follow-up. The color of the urine requires follow-up evaluation.
Question 3
A 25 year-old client, unresponsive after a motor vehicle accident, is being transferred from the hospital to a long term care facility. To which staff member should the charge nurse assign the client?
A) Unlicensed assistive personnel (UAP)
B) Senior nursing student
C) PN
D) RN
Review Information: The correct answer is D: RN
The RN is responsible for teaching and assessment associated with discharge and these activities cannot be delegated to the others listed.
Question 4
A practical nurse (PN) from the pediatric unit is assigned to work in a critical care unit. Which client assignment would be appropriate?
A) A client admitted with multiple trauma with a history of a newly implanted pacemaker
B) A new admission with left-sided weakness from a stroke and mild confusion
C) A 53 year-old client diagnosed with cardiac arrest from a suspected myocardial infarction
D) A 35 year-old client in balanced traction admitted 6 days ago after a motor vehicle accident
Review Information: The correct answer is D: A 35 year-old client in balanced traction admitted 6 days ago after a motor vehicle accident
This client is the most stable with a predictable outcome.
Question 5
A client has had a tracheostomy for 2 weeks after a motor vehicle accident. Which task could the RN safely delegate to unlicensed assistive personnel (UAP)?
A) Teach the client how to cough up secretions
B) Changes the tracheostomy trach ties
C) Monitor if client has shortness of breath
D) Perform routine tracheostomy dressing care
Review Information: The correct answer is D: Perform routine tracheostomy dressing care
Unlicensed assistive personnel should be able to perform routine tracheostomy care.
Question 6
An unlicensed assistive personnel (UAP), who usually works in pediatrics is assigned to work on a medical-surgical unit. Which one of the questions by the charge nurse would be most appropriate prior to making delegation decisions?
A) "How long have you been a UAP?”
B) "What type of care did you give in pediatrics?”
C) "Do you have your competency checklist that we can review?”
D) "How comfortable are you to care for adult clients?”
Review Information: The correct answer is C: "Do you have your competency checklist that we can review?”
The UAP must be competent to accept the delegated task. Further assessment of the qualifications of the UAP is important in order to assign the right task.
Question 7
An RN from the women’s health clinic is temporarily reassigned to a medical-surgical unit. Which of these client assignments would be most appropriate for this nurse?
A) A newly diagnosed client with type 2 diabetes mellitus who is learning foot care
B) A client from a motor vehicle accident with an external fixation device on the leg
C) A client admitted for a barium swallow after a transient ischemic attack
D) A newly admitted client with a diagnosis of pancreatic cancer
Review Information: The correct answer is B: A client from a motor vehicle accident with an external fixation device on the leg
This client is the most stable, requires basic safety measures and has a predictable outcome.
Question 8
The RN delegates the task of taking vital signs of all the clients on the medical-surgical unit to an unlicensed assistive personnel (UAP). Specific written and verbal instructions are given to not take a post-mastectomy client’s blood pressure on the left arm. Later as the RN is making rounds, the nurse finds the blood pressure cuff on that client’s left arm. Which of these statements is most immediately accurate?
A) The RN has no accountability for this situation
B) The RN did not delegate appropriately
C) The UAP is covered by the RN’s license
D) The UAP is responsible for following instructions
Review Information: The correct answer is D: The UAP is responsible for following instructions
The UAP is responsible for carrying out the activity correctly once directions have been clearly communicated especially if given verbally and in writing.
Question 9
The nurse in a same-day surgery unit assigns the unlicensed assistive personnel (UAP) to provide a hernia patient with a lunch tray. Which statement by the nurse is most appropriate?
A) "Tell the family they can bring in a pizza if the patient would prefer that."
B) "Make sure the patient gets at least 2 cartons of milk."
C) "Stop the IV if the patient is able to eat solid food."
D) "Encourage the patient to eat slowly to prevent gas."
Review Information: The correct answer is D: "Encourage the patient to eat slowly to prevent gas."
The professional nurse can delegate tasks with an expected outcome. The UAP is given adequate information about the task and how to promote the best outcome.
Question 10
A staff nurse complains to the nurse manager that an unlicensed assistive personnel (UAP) consistently leaves the work area untidy and does not restock supplies. The best initial response by the nurse manager is which of these statements?
A) "I will arrange for a conference with you and the UAP within the next week"
B) "I can assure you that I will look into the matter"
C) "I would like for you to approach the UAP about the problem the next time it occurs"
D) I will add this concern to the agenda for the next unit meeting
Review Information: The correct answer is C: "I would like for you to approach the UAP about the problem the next time it occurs"
Helping staff manage conflict is part of the manager''s role. It is appropriate to urge the nurse to confront the other staff member to work out problems without a manager''s intervention when possible.
Question 11
The home care nurse has been managing a client for 6 weeks. What is the best method to determine the quality of care provided by a home health care aide assigned to assist with the care of this client?
A) Ask the client and family if they are satisfied with the care given
B) Determine if the home health aide's care is consistent with the plan of care
C) Investigate if the home health aide is prompt and stays an appropriate length of time for care
D) Check the documentation of the aide for appropriateness and comprehensiveness
Review Information: The correct answer is B: Determine if the home health aide''s care is consistent with the plan of care
Although the nurse must complete all of the above responsibilities, evaluation of an adherence to the plan of care is the first priority. The plan of care is based on the reason for referral, provider''s orders, the initial nursing assessment, the client’s responses to the planned interventions, and the client''s and family''s feedback or inquires. The other possible answers represent aspects of accomplishing “B”.
Question 12
The nurse assigns an unlicensed assistive personnel (UAP) to care for a client with a musculoskeletal disorder. The client ambulates with a leg splint. Which task requires supervision of the UAP?
A) Report signs of redness overlying a joint
B) Monitor the client's response to ambulatory activity
C) Encouragement for the independence in self-care
D) Assist the client to transfer from a bed to a chair
Review Information: The correct answer is B: Monitor the client''s response to ambulatory activity
Monitoring the client’s response to interventions requires assessment, a task to be performed by an RN.
Question 13
The care of which of the following clients can the nurse safely delegate to an unlicensed assistive personnel (UAP)?
A) A client with peripheral vascular disease and an ulceration of the lower leg.
B) A pre-operative client awaiting adrenalectomy with a history of asthma
C) An elderly client with hypertension and self-reported non-compliance
D) A new admission with a history of transient ischemic attacks and dizziness
Review Information: The correct answer is A: A client with peripheral vascular disease and an ulceration of the lower leg.
This client is stable with no risk of instability as compared to the other clients. And this client has a chronic condition, needs supportive care.
Question 14
A charge nurse working in a long term care facility is making out assignments. Which assignment made by a registered nurse to an unlicensed assistive personnel (UAP) requires intervention by the supervisor?
A) Provide decubitus ulcer care and apply a dry dressing
B) Bathe and feed a client on bed rest
C) Oral suctioning of an unresponsive elderly client
D) Teaching a family intermittent (bolus) feedings via G-tube before discharge
Review Information: The correct answer is D: Teaching a family intermittent (bolus) feedings via G-tube before discharge. Initial teaching can not be delegated to a UAP or a PN and must be done by RNs.
Question 15
As the RN responsible for a client in isolation, which can be delegated to the practical nurse (PN)?
A) Reinforcement of isolation precautions
B) Assessment of the client's attitude about infection control
C) Evaluation of staffs' compliance with control measures
D) Observation of the client's total environment for risks
Review Information: The correct answer is A: Reinforcement of isolation precautions
PNs and UAPs can reinforce information that was originally given by the RN.
Question 16
When walking past a client’s room, the nurse hears 1 unlicensed assistive personnel (UAP) talking to another UAP. Which statement requires follow-up intervention?
A) "If we work together we can get all of the client care completed."
B) "Since I am late for lunch, would you do this one client's glucose test?"
C) "This client seems confused, we need to watch monitor closely."
D) "I’ll come back and make the bed after I go to the lab."
Review Information: The correct answer is B: "Since I am late for lunch, would you do this one client''s glucose test?"
Only the RN and PN can delegate to UAPs. One UAP can not delegate a task to another UAP. The RN or PN is legally accountable for the nursing care.
Question 17
Which of these clients would be appropriate to assign to a practical nurse (PN)?
A) A trauma victim with multiple lacerations and requires complex dressings
B) An elderly client with cystitis and an indwelling urethral catheter
C) A confused client whose family complains about the nursing care 2 days after surgery
D) A client admitted for possible transient ischemic attack with unstable neurological signs
Review Information: The correct answer is B: An elderly client with cystitis and an indwelling urethral catheter
This is a stable client, with predictable outcome and care and minimal risk for complications.
Question 18
Which of these clients would be most appropriate to assign to a practical nurse (PN)?
A) A trauma victim with quadriplegia and a client 1 day post-op radical neck dissection
B) A client with newly diagnosed type 2 diabetes mellitus and a client with a history of AIDS admitted for pneumonia
C) A client with hemiplegia is fed by a nasogastric tube and client with a left leg amputation in rehabilitation
D) A client with a history of schizophrenia in alcohol withdrawal and a client with chronic renal failure
Review Information: The correct answer is C: A client with hemiplegia is fed by a nasogastric tube and client with a left leg amputation in rehabilitation
This client requires supportive care and interventions within the scope of practice of a PN. This client is stable with little risk of complications or instability.
Question 19
The charge nurse on a cardiac step-down unit makes assignments for the team consisting of a registered nurse (RN), a practical nurse (PN), and an unlicensed assistive personnel (UAP). Which client should be assigned to the PN?
A) A 49 year-old with new onset atrial fibrillation with a rapid ventricular response
B) A 58 year-old hypertensive with possible angina
C) A 35 year-old scheduled for cardiac catheterization
D) A 65 year-old for discharge after angioplasty and stent placement
Review Information: The correct answer is B: A 58 year-old hypertensive with possible angina
This is the most stable client. The clients in options C and D require initial teaching. The client in option A is considered unstable since the dysrhythmia is a new onset.
Question 20
Which task for a client with anemia and confusion could the nurse delegate to the unlicensed assistive personnel (UAP)?
A) Assess and document skin turgor and color changes
B) Test stool for occult blood and urine for glucose and report results
C) Suggest foods high in iron and those easily consumed
D) Report mental status changes and the degree of mental clarity
Review Information: The correct answer is B: Test stool for occult blood and urine for glucose and report results
The UAP can do standard, unchanging procedures that require no decision making.
Question 21
During the interview of a prospective employee who just completed the agency orientation, which approach would be the best for the nurse manager to use to assess competence?
A) "What degree of supervision for basic care do you think you need?"
B) "Let’s review your skills check-list for type and level of skill"
C) "Are you comfortable working independently?"
D) "What client care tasks or assignments do you prefer?"
Review Information: The correct answer is B: "Let’s review your skills check-list for type and level of skill"
The nurse needs to know that the employee has competence in certain tasks. One way to do this is to do mutual review of documented skills.
Question 22
A client is receiving an intravenous (IV) infusion for pain control. When caring for this client, which one of these actions can the RN safely assign to an unlicensed assistive personnel (UAP)?
A) Ask the client the degree of relief and document the client’s response
B) Decrease the set rate on the pump by 2 ml/minute
C) Check the IV site for drainage and loose tape
D) Assist the client with ambulation and a gown change with supervision
Review Information: The correct answer is D: Assist the client with ambulation and a gown change with supervision
When directing the UAP, communicate clearly and specifically what the task is and what should be reported to the nurse. Implementation of routine tasks should be delegated since they do not require independent judgment.
Question 23
Which one of these tasks can be safely delegated to a practical nurse (PN)?
A) Assess the function of a newly created ileostomy
B) Care for a client with a recent complicated double barrel colostomy
C) Provide stoma care for a client with a well functioning ostomy
D) Teach ostomy care to a client and their family members
Review Information: The correct answer is C: Provide stoma care for a client with a well functioning ostomy
The care of a mature stoma and the application of an ostomy appliance may be delegated to a PN. This client has minimal risk of instability of the situation.
Question 24
Which statement by the nurse is appropriate when giving an assignment to an unlicensed assistive personnel (UAP) to help a client ambulate for the first time after a colon resection?
A) "Have the client sit on the side of the bed before helping the client to walk."
B) "If the client is dizzy ask the client to take some slow, deep breaths."
C) "Help the client to walk in the room as often as the client wishes."
D) "When you help the client to walk, ask if any pain occurs."
Review Information: The correct answer is A: "Have the client sit on the side of the bed before helping the client to walk."
This statement gives clear directions to the UAP about the task and is most closely associated with the information provided in the stem that this is the client''s first time out of bed after surgery.
Question 25
Two people call in sick on the medical-surgical unit and no additional help is available. The team consists of an RN, an LPN and an unlicensed assistive personnel (UAP). Which of these activities should the nurse assign to the UAP?
A) Assist with plans for any clients discharged
B) Provide basic hygiene care to all clients on the unit
C) Assess a client after an acute myocardial infarction
D) Gather the vital signs of all clients on the unit
Review Information: The correct answer is B: Provide basic hygiene care to all clients on the unit
Basic client care, which is routine, should be delegated to a UAP since the unit is short on help. The vital signs can be done by the RN and PN as they make rounds since this data is more critical to making decisions about the care of the clients.
NCLEX Nursing Review for RN & LVN In Los Angeles
Join this intense 32-hour NCLEX RN/LVN review which has a passing rate of 85%. You are sure to learn things that are not covered at other reviews or institutions giving you the knowledge and confidence needed to pass.
Fees for the review are $350 for LVN’s and $375 Feel free to contact us if you have any questions at (323) 610 - 5169. You can email us at admissions@sycamorenurses.com or visit us at http://www.sycamorenurses.com
Fees for the review are $350 for LVN’s and $375 Feel free to contact us if you have any questions at (323) 610 - 5169. You can email us at admissions@sycamorenurses.com or visit us at http://www.sycamorenurses.com
Medical Assistant or LVN Jobs In Glendale California
Full-time experienced and reliable Medical Assistant or LVN needed for Urology Clinic in Glendale,California.
Must have 2 years minimum experience as a Medical Assistant or LVN. Applicant must also be bilingual in either Tagalog, Spanish or Armenian. This busy Urology practice is looking for a highly motivated, skilled and intelligent individual that should live within 20 miles of the practice. fax resume to 818-241-1652.
Must have 2 years minimum experience as a Medical Assistant or LVN. Applicant must also be bilingual in either Tagalog, Spanish or Armenian. This busy Urology practice is looking for a highly motivated, skilled and intelligent individual that should live within 20 miles of the practice. fax resume to 818-241-1652.
CNA Jobs In California
Maxim Healthcare Services is seeking for Certified Nursing Assistants(CNA)with experience in Hospitals.
Requirements for this position include:
-Current CNA Certificate in California
-Current Healthcare Provider CPR Card and First Aid
-Immunization records and current physical examinations
-Current TB test or Chest X-Ray
-One year+ experience is preferred
Benefits include:
-Medical, Dental, Vision, and Life Insurance
-401k Program
-Competitive Pay
-Flexible Scheduling
-Direct Deposit
-Positive Work Environment and Friendly Staff Bonuses
-24 hour on-call service
Contact Maxim Healthcare Services
1111 S. Arroyo Pkwy Ste. 430
Pasadena, CA 91105
Phone: (626) 799-2688
Fax: (626) 799-2698
or email pasadenaca@maxhealth.com
Requirements for this position include:
-Current CNA Certificate in California
-Current Healthcare Provider CPR Card and First Aid
-Immunization records and current physical examinations
-Current TB test or Chest X-Ray
-One year+ experience is preferred
Benefits include:
-Medical, Dental, Vision, and Life Insurance
-401k Program
-Competitive Pay
-Flexible Scheduling
-Direct Deposit
-Positive Work Environment and Friendly Staff Bonuses
-24 hour on-call service
Contact Maxim Healthcare Services
1111 S. Arroyo Pkwy Ste. 430
Pasadena, CA 91105
Phone: (626) 799-2688
Fax: (626) 799-2698
or email pasadenaca@maxhealth.com
Jobs For LVN/LPN or Medical Assistant
Platinum Healthcare Staffing, a leading nursing staffing firm in Southern California is seeking for an LVN/LPN or a Medical Assistant who can work in an medical office Monday- Friday. Candidate must have a current California License, CPR/1st Aid, Computer literate, between 28-40 years old, Physically fit and BILINGUAL (Spanish).
For more information, please call us at (877)821-5888 or fax your resume at (310)821-6888 or apply online at www.platinumhealthcarestaffing.com
For more information, please call us at (877)821-5888 or fax your resume at (310)821-6888 or apply online at www.platinumhealthcarestaffing.com
Weekend And Evening Shift RN LVN LPN Jobs
Looking for energetic nurses (RN or LPN) to work Saturdays and Sundays day and evening shifts). This would be 2 eight hour shifts each day.
This position is for a charge nurse on a skilled nursing unit with mostly short term rehab patients. Competitive wage and benefits. Contact Karen at 360-568-3161 or email Karen@merryhaven.com
This position is for a charge nurse on a skilled nursing unit with mostly short term rehab patients. Competitive wage and benefits. Contact Karen at 360-568-3161 or email Karen@merryhaven.com
Director Of Clinical Services RN
Maxim Healthcare Services,one of the leading providers of medical staffing, home health and wellness services in the United States is looking for a qualified Director of Clinical Services (RN).
Duties and responsibilities include:
-Developing plans of treatment for our medically fragile patients
-Organizes and directs the clinical operations of the office
-Staff supervision
-Competency evaluations of clinical staff
-Organizes orientation and training of Maxim employees
-Partnering with the Account Manager to maintain financial stability
Qualifications
Required:
-Current state license as a RN, BSN preferred
-Current CPR
-Thorough knowledge of State, Federal, and ACHC regulations
-At least 2 years work experience including one year of pediatric experience
-Current state driver’s license and automobile insurance
-Proficient in computers
Preferred:
-One year in homecare management
-Previous supervisory or administrative role
-Leadership skills
Send your resumes by email at megaylor@maxhealth.com or contact Megan at 360-456-1680.
Duties and responsibilities include:
-Developing plans of treatment for our medically fragile patients
-Organizes and directs the clinical operations of the office
-Staff supervision
-Competency evaluations of clinical staff
-Organizes orientation and training of Maxim employees
-Partnering with the Account Manager to maintain financial stability
Qualifications
Required:
-Current state license as a RN, BSN preferred
-Current CPR
-Thorough knowledge of State, Federal, and ACHC regulations
-At least 2 years work experience including one year of pediatric experience
-Current state driver’s license and automobile insurance
-Proficient in computers
Preferred:
-One year in homecare management
-Previous supervisory or administrative role
-Leadership skills
Send your resumes by email at megaylor@maxhealth.com or contact Megan at 360-456-1680.
Night Shift LPN/LVN Position In New York
Work full time in a 140 Bed Long Term Care/ Short Term Sub-acute Facility in Queens,New York.Easily accessible by mass transportation, seeking self-directed NIGHT SHIFT LPN/LVN.
Experienced preferred, but will train strong beginner with previous management/ leadership experience. This position reports to the D.N.S. and supervises CNAs.
REQUIREMENTS:
- New York State License
- Nursing experience preferred; previous leadership experience required
- Professional references
SALARY: $23.85 per hour ($21.47 + 10% night differential)
1199 UNION BENEFITS:
- Paid vacation
- Paid sick days
- Paid personal days
- Paid holidays
- Medical,
- Dental,
- Prescription,
- Vision
Submit your resume to:SumbitMyResume@DNGPlacement.com or Fax: 516.579.1942
Experienced preferred, but will train strong beginner with previous management/ leadership experience. This position reports to the D.N.S. and supervises CNAs.
REQUIREMENTS:
- New York State License
- Nursing experience preferred; previous leadership experience required
- Professional references
SALARY: $23.85 per hour ($21.47 + 10% night differential)
1199 UNION BENEFITS:
- Paid vacation
- Paid sick days
- Paid personal days
- Paid holidays
- Medical,
- Dental,
- Prescription,
- Vision
Submit your resume to:SumbitMyResume@DNGPlacement.com or Fax: 516.579.1942
Nursing Coordinator Position In New York
Seeking a Nurse Coordinator to implement, manage, and evaluate the provision of both professional and ancillary home health services to ensure that all patients’ needs are met and quality care is provided.
Graduate of an accredited school of Nursing required (BSN preferred). Current Registered Nurse registration with NYS Department of Education required.
We offer an excellent salary and benefits. Forward resume to: hr@extendedhc.net or Fax: (212) 563-0775.
Graduate of an accredited school of Nursing required (BSN preferred). Current Registered Nurse registration with NYS Department of Education required.
We offer an excellent salary and benefits. Forward resume to: hr@extendedhc.net or Fax: (212) 563-0775.
Looking For Quality Assurance Nurse
Currently seeking a part-time to full-time Nurse to act as a utilization review quality assurance supervisor. The position will be responsible for:
1. Providing Quality Assurance of the independent medical reviews.
2. Performing Utilization Management services within established clinical, productivity, phone and URAC standards.
3. Applying clinical skills and expertise in conjunction with established medical criteria to ensure independent reviews are accurate and complete.
4. Serve as subject matter expert on complex medical management issues.
5. Performing other related projects and duties as assigned.
Accountabilities:
1. Responsible for assessing and monitoring services for inpatient, outpatient, home health care and skilled nursing facilities utilizing thorough knowledge of multiple criteria sets and products.
2. Responsible for maintaining knowledge of community resources and health plan programs.
3. Responsible for preparing documentation to provide the utmost quality of reviews.
4. Responsible for facilitating consistent, sound and defensible medical decisions, according to established coverage guidelines/policies, national industry-standard care guidelines, and current scientific evidence as it applies to each case
5. Efficiently and accurately communicate necessary changes for the non-medical staff following established timelines.
6. Evaluate and analyze available literature on new and existing technologies to determine safety and effectiveness as it relates to the quality of independent reviews.
7. Ability to abstract pertinent clinical findings and appropriately apply to corresponding clinical criteria.
8. Maintain confidentiality of case information.
9. Other duties as assigned
Required Qualifications:
1. Currently licensed Registered Nurse preferably B.S.N.
2. Five years of experience as an RN in medical/surgical, critical care, home care, or equivalent knowledge of current hospital and clinical care processes
3. Experience in utilization review, utilization management, quality review or discharge planning
4. Excellent verbal and written communication and interpersonal skills
5. Excellent problem identification/problem solving and follow through skills
6. Ability to organize and prioritize multiple assignments within workload
7. Ability to function independently and take independent action, within the scope of job responsibilities.
Preferred Qualifications:
1. Experience in managed care environment
2. Experience in working with established criteria to determine medical necessity and appropriateness of care
3. Demonstrated knowledge and familiarity in research methodologies and ability to interpret medical literature.
4. Computer experience with word processing, spreadsheets, data base management
5. Bachelor of Science in Nursing
Apply at www.admere.com.
1. Providing Quality Assurance of the independent medical reviews.
2. Performing Utilization Management services within established clinical, productivity, phone and URAC standards.
3. Applying clinical skills and expertise in conjunction with established medical criteria to ensure independent reviews are accurate and complete.
4. Serve as subject matter expert on complex medical management issues.
5. Performing other related projects and duties as assigned.
Accountabilities:
1. Responsible for assessing and monitoring services for inpatient, outpatient, home health care and skilled nursing facilities utilizing thorough knowledge of multiple criteria sets and products.
2. Responsible for maintaining knowledge of community resources and health plan programs.
3. Responsible for preparing documentation to provide the utmost quality of reviews.
4. Responsible for facilitating consistent, sound and defensible medical decisions, according to established coverage guidelines/policies, national industry-standard care guidelines, and current scientific evidence as it applies to each case
5. Efficiently and accurately communicate necessary changes for the non-medical staff following established timelines.
6. Evaluate and analyze available literature on new and existing technologies to determine safety and effectiveness as it relates to the quality of independent reviews.
7. Ability to abstract pertinent clinical findings and appropriately apply to corresponding clinical criteria.
8. Maintain confidentiality of case information.
9. Other duties as assigned
Required Qualifications:
1. Currently licensed Registered Nurse preferably B.S.N.
2. Five years of experience as an RN in medical/surgical, critical care, home care, or equivalent knowledge of current hospital and clinical care processes
3. Experience in utilization review, utilization management, quality review or discharge planning
4. Excellent verbal and written communication and interpersonal skills
5. Excellent problem identification/problem solving and follow through skills
6. Ability to organize and prioritize multiple assignments within workload
7. Ability to function independently and take independent action, within the scope of job responsibilities.
Preferred Qualifications:
1. Experience in managed care environment
2. Experience in working with established criteria to determine medical necessity and appropriateness of care
3. Demonstrated knowledge and familiarity in research methodologies and ability to interpret medical literature.
4. Computer experience with word processing, spreadsheets, data base management
5. Bachelor of Science in Nursing
Apply at www.admere.com.
RN Job Opening In Van Nuys California
A North Hollywood Home Health Care is looking for a Registered Nurse, who will provide nursing care to patient as prescribed by physician. We will provide training for the right candidate. Flexible hours and excellent salary. Full time/Part time. Wonderful career opportunity. e-mail your resume to: rubinaazaryan@yahoo.com
Sample Nursing Position Cover Letter
Sample cover letters are one of the important components in landing your desired dream job in a hospital setting. This is a sample cover letter that you may use when you apply for a nursing job.
Your Name
Address
Current Date
Contact's Name
Contact's Title
Name of Institution
Address of Institution
City, State, Zip
Dear Ms._____________:
I am seeking an RN position on a medical unit in your hospital. From the classified advertisements in the West County Journal, I understand that you have a position available.
As you can see from the attached resume, I have two years of experience caring for patients on a medical unit. I enjoy the professional relationships and opportunities for teaching available working with patients on a medical unit.
I wish to work at your hospital because of its excellent reputation for quality patient care. I have also performed volunteer work with nurses from your hospital who were very enthusiastic about the hospital environment and career advancement opportunities.
I am available for interviews the week of September 6, 2001. Please let me know if it would be convenient for you to meet with me then. My phone number is (555) 555-8888. I look forward to meeting you to discuss possible employment.
Sincerely,
[signature]
Your Name Typewritten
Enclosures
Your Name
Address
Current Date
Contact's Name
Contact's Title
Name of Institution
Address of Institution
City, State, Zip
Dear Ms._____________:
I am seeking an RN position on a medical unit in your hospital. From the classified advertisements in the West County Journal, I understand that you have a position available.
As you can see from the attached resume, I have two years of experience caring for patients on a medical unit. I enjoy the professional relationships and opportunities for teaching available working with patients on a medical unit.
I wish to work at your hospital because of its excellent reputation for quality patient care. I have also performed volunteer work with nurses from your hospital who were very enthusiastic about the hospital environment and career advancement opportunities.
I am available for interviews the week of September 6, 2001. Please let me know if it would be convenient for you to meet with me then. My phone number is (555) 555-8888. I look forward to meeting you to discuss possible employment.
Sincerely,
[signature]
Your Name Typewritten
Enclosures
Buy Wireless Display Blood Pressure Monitor
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Looking For A Flight Nurse
REACH Air Medical Services is a privately owned and operated stand-alone EMS helicopter and fixed-wing provider headquartered in Santa Rosa, California. REACH offers a dynamic, team-oriented atmosphere for motivated individuals who are interested in taking their career to new heights!
REACH has flown more than 40,000 patients since its inception in 1987, responding to scene and inter-facility patient transport requests. Specializing in the rapid assessment, intervention and safe transport of critically ill or injured pediatric patients, REACH has been the primary provider of air ambulance services for Children’s Hospital and Research Center Oakland since 1993. CAMTS accredited since 1998, REACH conducts all patient transport services through our dedicated, satellite-based Communications Center at our Santa Rosa headquarters.
Areas of service include operations in California and Oregon and we’re growing! Our current fleet includes Agusta A109, Bell 407 and Eurocopter EC135 helicopters as well as King Air B200 and Cessna 421C airplanes to perform high quality, customer-oriented patient care in a safe and efficient manner.
The REACH clinical staff of flight nurses, paramedics and respiratory therapists join REACH with extensive experience within their specialty areas. They undergo thorough clinical rotations, internal training and continuing education. REACH has established several areas of clinical specialty services. In addition to adult medical and trauma patients, our teams are prepared to care for and transport neonatal, pediatric, and high-risk obstetric patients.
REACH has demonstrated a superior commitment to patient care since its inception. Our guiding principle is simple: "Always do what is right for the patient." As REACH continues to GROW, we would like to invite you to take advantage of this GREAT opportunity! If you are seeking the most challenging environment and dynamic group of peers to work with then this is the job for you! The REACH Team welcomes you to this experience.
Flight Nurse Qualifications:
•Graduate of an accredited School of Nursing
•Current California RN license.
•Minimum of 3 years critical care or emergency care experience (>1 year of adult ICU preferred)
•Current ACLS, BCLS, PALS and NRP provider.
•Must maintain a duty weight of less than 210 lbs (body weight, uniform and equipment)
The next step is yours! To apply online for this exciting opportunity in Southern California, please go to:
https://home.eease.com/recruit/?id=150281
REACH is an Equal Opportunity Employer
Contact:
Human Resources
451 Aviation Blvd., Suite 201
Santa Rosa, CA 95403
hr@reachair.com Fax: 888-511-7633
REACH has flown more than 40,000 patients since its inception in 1987, responding to scene and inter-facility patient transport requests. Specializing in the rapid assessment, intervention and safe transport of critically ill or injured pediatric patients, REACH has been the primary provider of air ambulance services for Children’s Hospital and Research Center Oakland since 1993. CAMTS accredited since 1998, REACH conducts all patient transport services through our dedicated, satellite-based Communications Center at our Santa Rosa headquarters.
Areas of service include operations in California and Oregon and we’re growing! Our current fleet includes Agusta A109, Bell 407 and Eurocopter EC135 helicopters as well as King Air B200 and Cessna 421C airplanes to perform high quality, customer-oriented patient care in a safe and efficient manner.
The REACH clinical staff of flight nurses, paramedics and respiratory therapists join REACH with extensive experience within their specialty areas. They undergo thorough clinical rotations, internal training and continuing education. REACH has established several areas of clinical specialty services. In addition to adult medical and trauma patients, our teams are prepared to care for and transport neonatal, pediatric, and high-risk obstetric patients.
REACH has demonstrated a superior commitment to patient care since its inception. Our guiding principle is simple: "Always do what is right for the patient." As REACH continues to GROW, we would like to invite you to take advantage of this GREAT opportunity! If you are seeking the most challenging environment and dynamic group of peers to work with then this is the job for you! The REACH Team welcomes you to this experience.
Flight Nurse Qualifications:
•Graduate of an accredited School of Nursing
•Current California RN license.
•Minimum of 3 years critical care or emergency care experience (>1 year of adult ICU preferred)
•Current ACLS, BCLS, PALS and NRP provider.
•Must maintain a duty weight of less than 210 lbs (body weight, uniform and equipment)
The next step is yours! To apply online for this exciting opportunity in Southern California, please go to:
https://home.eease.com/recruit/?id=150281
REACH is an Equal Opportunity Employer
Contact:
Human Resources
451 Aviation Blvd., Suite 201
Santa Rosa, CA 95403
hr@reachair.com Fax: 888-511-7633
Medical Office Assistant/ Admin Jobs
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Office: 310.454.0317
• Looking for an assistant/admin
• High-tech, state of the art facility
• Excellent opportunity for Full time position
• Will train and reward generously
Please come in to meet us and see our offices. Interviews Monday-Thursday 1:30PM --No appointment necessary. Please call.
881 Alma Real Dr. #200
Pacific Palisades, CA 90272
Office: 310.454.0317
Promotion Of Safety Questions For NCLEX-RN
Question Number 1 of 20
Which of these clients is the priority for the nurse to report to the public health department within the next 24 hours?
A) An infant with a positive culture of stool for Shigella
B) An elderly factory worker with a lab report that is positive for acid-fast bacillus smear
C) A young adult commercial pilot with a positive histopathological examination from an induced sputum for Pneumocystis carinii
D) A middle-aged nurse with a history of varicella zoster virus and with crops of vesicles on an erythematous base that appear on the skin
The correct answer is B: An elderly factory worker with a lab report that is positive for acid-fast bacillus smear Tuberculosis is a reportable disease because persons who had contact with the client must be traced and often must be treated with chemoprophylaxis for a designated time. Options A and D may need contact isolation precautions. Option C -- findings may indicate the initial stage of autoimmune deficiency syndrome (AIDS).
Question Number 2 of 20
The parents of a toddler who is being treated for pesticide poisoning ask: “Why is activated charcoal used? What does it do?” What is the nurse's best response?
A) "Activated charcoal decreases the body’s absorption of the poison from the stomach."
B) "The charcoal absorbs the poison and forms a compound that doesn't hurt your child."
C) "This substance helps to get the poison out of the body through the gastrointestinal system." D) "The action may bind or inactivate the toxins or irritants that are ingested by children and adults."
The correct answer is B: "The charcoal absorbs the poison and forms a compound that doesn''t hurt your child."
All of the options are correct responses. However, option B is most accurate information to answer the parents’ questions about the use and action of activated charcoal. The language is appropriate for a parent''s understanding.
Question Number 3 of 20
Which of these nursing diagnoses, appropriate for elderly clients, would indicate the client is at greatest risk for falls?
A) Sensory perceptual alterations related to decreased vision
B) Alteration in mobility related to fatigue
C) Impaired gas exchange related to retained secretions
D) Altered patterns of urinary elimination related to nocturia
The correct answer is D: Altered patterns of urinary elimination related to nocturia
Nocturia is especially problematic because many elders fall when they rush to reach the bathroom at night. They may be confused or not fully alert. Inadequate lighting can increase their chances of stumbling, and then they may fall over furniture or carpets.
Question Number 4 of 20
A nurse who is assigned to the emergency department needs to understand that gastric lavage is a priority in which situation?
A) An infant who has been identified as suffering from botulism
B) A toddler who has eaten a number of ibuprofen tablets
C) A preschooler who has swallowed powdered plant food
D) A school aged child who has taken a handful of vitamins
The correct answer is A: An infant who has been identified as suffering from botulism
C. botulinum forms a toxin in improperly processed foods in anaerobic conditions. It is a neurotoxin that impairs autonomic and voluntary neurotransmission and causes muscular paralysis. Findings appear within 36 hours of ingestion. The nurse should be aware that all of these clients may be candidates for gastric lavage or for activated charcoal administration.
Question Number 5 of 20
The nurse is to administer a new medication to a client. Which of these actions best demonstrate awareness of safe, proficient nursing practice?
A) Verify the order for the medication. Prior to giving the medication the nurse should say, "Please state your name."
B) Upon entering the room the nurse should ask: "What is your name? What allergies do you have?" and then check the client's name band and allergy band.
C) As the room is entered say "What is your name?" then check the client's name band.
D) Verify the client's allergies on the admission sheet and order. Verify the client's name on the name plate outside the room then as the nurse enters the room ask the client "What is your first, middle and last name?"
The correct answer is B: Upon entering the room the nurse should ask: "What is your name? What allergies do you have?" and then check the client''s name band and allergy band.
A dual check is always done for a client''s name. This would involve verbal and visual checks. Since this is a new medication an allergy check is appropriate.
Question Number 6 of 20
A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia (MRSA). What type of isolation is most appropriate for this client?
A) Reverse
B) Airborne
C) Standard precautions
D) Contact
The correct answer is D: Contact
Contact precautions or Body Substance Isolation (BSI) involves the use of barrier protection (e.g. gloves, mask, gown, or protective eyewear as appropriate) whenever direct contact with any body fluid is expected. When determining the type of isolation to use, one must consider the mode of transmission. The hands of personnel continue to be the principal mode of transmission for methicillin resistant staphylococcus aureus (MRSA). Because the organism is limited to the sputum in this example, precautions are taken if contact with the patient''s sputum is expected. A private room and contact precautions , along with good hand washing techniques, are the best defenses against the spread of MRSA pneumonia.
Question Number 7 of 20
A school nurse has a 10 year-old child with a history of epilepsy with tonic-clonic seizures attending classes regularly. The school nurse should inform the teacher that if the child experiences a seizure in the classroom, the most important action to take during the seizure would be to
A) move any chairs or desks at least 3 feet away from the child
B) note the sequence of movements with the time lapse of the event
C) provide privacy as much as possible to minimize frightening the other children
D) place the hands or a folded blanket under the head of the child
The correct answer is D: place the hands or a folded blanket under the head of the child
The priority during seizure activity is to protect the person from physical injury. Place a pillow, folded blanket or your hands under the child''s head to prevent concussion or other head trauma. The other body parts are at less risk for injury, consequently the prioritized sequence of the actions above would be options D, A, B, and C.
Question Number 8 of 20
A parent calls the hospital hot line and is connected to the triage nurse. The caller proclaims: “I found my child with odd stuff coming from the mouth and an unmarked bottle nearby.” Which of these comments would be the best tool for the nurse to determine if the child has swallowed a corrosive substance?
A) "Ask the child if the mouth is burning or throat pain is present."
B) "Take the child’s pulse at the wrist and see if the child is has trouble breathing lying flat."
C) "What color is the child’s lips and nails and has the child voided today?"
D) "Has the child had vomiting, diarrhea or stomach cramps?"
Your response was "A".
The correct answer is A: "Ask the child if the mouth is burning or throat pain is present."
Local irritation of tissues indicates a corrosive poisoning. The other comments may be helpful in determining the child’s overall condition, however the question concerns evaluation for ingesting a caustic substance.
Which of these actions is the primary nursing intervention designed to limit transmission of a client’s Salmonella infection?
A) Wash hands thoroughly before and after client contact
B) Wear gloves when in contact with body secretions
C) Double glove when in contact with feces or vomitus
D) Wear gloves when disposing of contaminated linens
The correct answer is A: Wash hands thoroughly before and after client contact
Gram-negative bacilli cause Salmonella infection, and lack of sanitation is the primary means of contamination. Two million new cases appear each year. Thorough handwashing can prevent the spread of salmonella. Note that all of the options are appropriate activities, but handwashing is primary.
Question Number 10 of 20
After an explosion at a factory one of the employees approaches the nurse and says “I am an unlicensed assistive personnel (UAP) at the local hospital.” Which of these tasks should the nurse assign first to this worker who wants to help care for the wounded workers?
A) Get temperatures
B) Take blood pressure
C) Palpate pulses
D) Check alertness
The correct answer is C: Palpate pulses
The heart rates would indicate if the client is in shock or has potential for shock. If the pulses could not be palpated, those clients would need to be seen first.
Question Number 11 of 20
A newly admitted adult client has a diagnosis of hepatitis A. The charge nurse should reinforce to the staff members that the most significant routine infection control strategy, in addition to handwashing, is which of these?
A) Place appropriate signs outside and inside the room
B) Use a mask with a shield if there is a risk of fluid splash
C) Wear a gown to change soiled linens from incontinence
D) Have gloves on while handling bedpans with feces
The correct answer is D: Have gloves on while handling bedpans with feces
The specific measure to prevent the spread of hepatitis A is careful handling and protection while working with fecal material. All of the other actions are correct but not the most significant specific approach used with hepatitis A.
Question Number 12 of 20
A nurse is reinforcing teaching with a client about compromised host precautions. The client is receiving filgrastim (Neupogen) for neutropenia. Which lunch selection suggests the client has learned about necessary dietary changes?
A) grilled chicken sandwich and skim milk
B) roast beef, mashed potatoes, and green beans
C) peanut butter sandwich, banana, and iced tea
D) barbeque beef, baked beans, and cole slaw
The correct answer is B: roast beef, mashed potatoes, and green beans
The client has correctly selected an appropriate lunch and appears to know the dietary restrictions. Low granulocyte counts and susceptibility to infection are expected. Compromised host precautions require that foods are either cooked or canned. Options A, C and D do not demonstrate learning, as raw fruits, vegetables, and milk are to be avoided.
Question Number 13 of 20
A client is scheduled to receive an oral solution of radioactive iodine (131I). In order to reduce hazards, the priority information for the nurse to include in client teaching is which of these statements?
A) "In the initial 48 hours, avoid contact with children and pregnant women, and flush the commode twice after urination or defecation."
B) "Use disposable utensils for 2 days and if vomiting occurs within 10 hours of the dose, do so in the toilet and flush it twice."
C) "Your family can use the same bathroom that you use without any special precautions."
D) "Drink plenty of water and empty your bladder often during the initial 3 days of therapy."
The correct answer is A: "In the initial 48 hours, avoid contact with children and pregnant women, and flush the commode twice after urination or defecation."
The client''s urine and saliva are radioactive for 24 hours after ingestion, and vomitus is radioactive for 6 to 8 hours. The client should drink 3 to 4 liters of fluid a day for the initial 48 hours to help remove the (131I) from the body. Staff should limit contact with hospitalized clients to 30 minutes per day per person
Question Number 14 of 20
Which approach is the best way to prevent infections when providing care to clients in the home setting?
A) Handwashing before and after examination of clients
B) Wearing nonpowdered latex-free gloves to examine the client
C) Using a barrier between the client's furniture and the nurse's bag
D) Wearing a mask with a shield during any eye/mouth/nose examination
The correct answer is A: Handwashing before and after examination of clients
Handwashing remains the most effective way to avoid spreading infection. However, too often nurses do not practice good handwashing techniques and do not teach families to do so. Nurses need to wash their hands before and after touching the client and before entering the nursing bag. All of the options are correct, and the sequence of priorities would be options A, C, B, and D.
Question Number 15 of 20
A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which admission orders should the nurse implement first?
A) Institute seizure precautions
B) Monitor neurologic status every hour
C) Place in respiratory/secretion precautions
D) Cefotaxime IV 50 mg/kg/day divided q6h
The correct answer is C: Place in respiratory/secretion precautions
Meningococcal meningitis is a bacterial infection that can be communicated to others. The initial therapeutic management of acute bacterial meningitis includes respiratory/secretions precautions, initiation of antimicrobial therapy, monitoring neurological status along with vital signs, instituting seizure precautions and lastly maintaining optimum hydration. The first action for nurses to take is initiate any necessary precautions to protect themselves and others from possible infection. Viral meningitis usually does not require protective measures of isolation.
Question Number 16 of 20
The nurse is assigned to a client newly diagnosed with active tuberculosis. Which of these interventions would be a priority for the nurse to implement?
A) Have the client cough into a tissue and dispose in a separate bag
B) Instruct the client to cover the mouth with a tissue when coughing
C) Reinforce that everyone should wash their hands before and after entering the room
D) Place client in a negative pressure private room and have all who enter the room use masks with shields
The correct answer is D: Place client in a negative pressure private room and have all who enter the room use masks with shields
A client with active tuberculosis should be hospitalized in a negative pressure room to prevent respiratory droplets from leaving the room when the door is opened. Tuberculosis (TB) is caused by spore-forming mycobacteria, more often Mycobacterium tuberculosis. In developed countries the infection is airborne and is spread by inhalation of infected droplets. In underdeveloped countries, transmission also occurs by ingestion or by skin invasion, particularly when bovine TB is poorly controlled.
Question Number 17 of 20
When an infant car seat is properly installed, the infant should face
A) forward, so child may look out window
B) backward, so child faces the seat
C) the side window, to increase sensory stimulation
D) upward, as child lies on back with seat installed sideways
The correct answer is B: backward, so child faces the seat
Nurses are now responsible for promoting the continued safety of infants and children outside of the hospital. Emergency Department and Women’s Services staff are trained in child seat placement. Growth and development data indicate that infants still require support of the head. Therefore, they should be positioned reclining and facing the rear until their leg muscles are strong enough to kick away from the backseat (about 10-12 months-old) for the greatest protection.
Question Number 18 of 20
Several clients are admitted to an adult medical unit. For which client condition(s) would the nurse institute airborne precautions?
A) Autoimmune deficiency syndrome (AIDS) with cytomegalovirus (CMV)
B) A positive purified protein derivative (PPD) test with an abnormal chest x-ray
C) A tentative diagnosis of viral pneumonia with productive brown sputum
D) Advanced carcinoma of the lung with hemoptysis
The correct answer is B: A positive purified protein derivative (PPD) test with an abnormal chest x-ray
The client who must be placed in airborne precautions is the client with these findings that suggest a suspicious tuberculin lesion. A sputum smear for acid fast bacillus would be done next. CMV usually causes no signs or symptoms in children and adults with healthy immune systems. Good handwashing is recommended for CMV. When signs and symptoms do occur, they are often similar to those of mononucleosis, including sore throat, fever, muscle aches and fatigue.
Question Number 19 of 20
The school nurse is teaching the faculty the most effective methods to prevent the spread of lice (Pediculus Humanus Capitis) in the school. The information that would be most important to include is reflected in which of these statements?
A) "The treatment medication requires reapplication in 8 to 10 days."
B) "Bedding and clothing can be boiled or steamed to kill lice."
C) "Children should not share hats, scarves and combs."
D) "Nit combs are necessary to comb lice eggs (nits) out of children's hair."
The correct answer is C: "Children should not share hats, scarves and combs."
Head lice live only on human beings and can be spread easily by sharing hats, combs, scarves, coats and other items of clothing that touch the hair. All of the options are correct statements, however they do not best answer the question of how to prevent the spread of lice in a school setting.
Question Number 20 of 20
Which of these clients would the nurse recommend keeping in the hospital during an internal disaster at that facility?
A) An adolescent diagnosed with sepsis 7 days ago and whose vital signs are maintained within low normal limits.
B) A middle-aged woman known to have had an uncomplicated myocardial infarction 4 days ago
C) An elderly man admitted 2 days ago with an acute exacerbation of ulcerative colitis
D) A young adult in the second day of treatment for an overdose of acetometaphen
The correct answer is D: A young adult in the second day of treatment for an overdose of acetometaphen
An overdose of Tylenol requires close observation for 3 to 4 days as well as Mucomyst PO during that time . A strong risk of liver failure exists immediately following Tylenol overdose.
Which of these clients is the priority for the nurse to report to the public health department within the next 24 hours?
A) An infant with a positive culture of stool for Shigella
B) An elderly factory worker with a lab report that is positive for acid-fast bacillus smear
C) A young adult commercial pilot with a positive histopathological examination from an induced sputum for Pneumocystis carinii
D) A middle-aged nurse with a history of varicella zoster virus and with crops of vesicles on an erythematous base that appear on the skin
The correct answer is B: An elderly factory worker with a lab report that is positive for acid-fast bacillus smear Tuberculosis is a reportable disease because persons who had contact with the client must be traced and often must be treated with chemoprophylaxis for a designated time. Options A and D may need contact isolation precautions. Option C -- findings may indicate the initial stage of autoimmune deficiency syndrome (AIDS).
Question Number 2 of 20
The parents of a toddler who is being treated for pesticide poisoning ask: “Why is activated charcoal used? What does it do?” What is the nurse's best response?
A) "Activated charcoal decreases the body’s absorption of the poison from the stomach."
B) "The charcoal absorbs the poison and forms a compound that doesn't hurt your child."
C) "This substance helps to get the poison out of the body through the gastrointestinal system." D) "The action may bind or inactivate the toxins or irritants that are ingested by children and adults."
The correct answer is B: "The charcoal absorbs the poison and forms a compound that doesn''t hurt your child."
All of the options are correct responses. However, option B is most accurate information to answer the parents’ questions about the use and action of activated charcoal. The language is appropriate for a parent''s understanding.
Question Number 3 of 20
Which of these nursing diagnoses, appropriate for elderly clients, would indicate the client is at greatest risk for falls?
A) Sensory perceptual alterations related to decreased vision
B) Alteration in mobility related to fatigue
C) Impaired gas exchange related to retained secretions
D) Altered patterns of urinary elimination related to nocturia
The correct answer is D: Altered patterns of urinary elimination related to nocturia
Nocturia is especially problematic because many elders fall when they rush to reach the bathroom at night. They may be confused or not fully alert. Inadequate lighting can increase their chances of stumbling, and then they may fall over furniture or carpets.
Question Number 4 of 20
A nurse who is assigned to the emergency department needs to understand that gastric lavage is a priority in which situation?
A) An infant who has been identified as suffering from botulism
B) A toddler who has eaten a number of ibuprofen tablets
C) A preschooler who has swallowed powdered plant food
D) A school aged child who has taken a handful of vitamins
The correct answer is A: An infant who has been identified as suffering from botulism
C. botulinum forms a toxin in improperly processed foods in anaerobic conditions. It is a neurotoxin that impairs autonomic and voluntary neurotransmission and causes muscular paralysis. Findings appear within 36 hours of ingestion. The nurse should be aware that all of these clients may be candidates for gastric lavage or for activated charcoal administration.
Question Number 5 of 20
The nurse is to administer a new medication to a client. Which of these actions best demonstrate awareness of safe, proficient nursing practice?
A) Verify the order for the medication. Prior to giving the medication the nurse should say, "Please state your name."
B) Upon entering the room the nurse should ask: "What is your name? What allergies do you have?" and then check the client's name band and allergy band.
C) As the room is entered say "What is your name?" then check the client's name band.
D) Verify the client's allergies on the admission sheet and order. Verify the client's name on the name plate outside the room then as the nurse enters the room ask the client "What is your first, middle and last name?"
The correct answer is B: Upon entering the room the nurse should ask: "What is your name? What allergies do you have?" and then check the client''s name band and allergy band.
A dual check is always done for a client''s name. This would involve verbal and visual checks. Since this is a new medication an allergy check is appropriate.
Question Number 6 of 20
A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia (MRSA). What type of isolation is most appropriate for this client?
A) Reverse
B) Airborne
C) Standard precautions
D) Contact
The correct answer is D: Contact
Contact precautions or Body Substance Isolation (BSI) involves the use of barrier protection (e.g. gloves, mask, gown, or protective eyewear as appropriate) whenever direct contact with any body fluid is expected. When determining the type of isolation to use, one must consider the mode of transmission. The hands of personnel continue to be the principal mode of transmission for methicillin resistant staphylococcus aureus (MRSA). Because the organism is limited to the sputum in this example, precautions are taken if contact with the patient''s sputum is expected. A private room and contact precautions , along with good hand washing techniques, are the best defenses against the spread of MRSA pneumonia.
Question Number 7 of 20
A school nurse has a 10 year-old child with a history of epilepsy with tonic-clonic seizures attending classes regularly. The school nurse should inform the teacher that if the child experiences a seizure in the classroom, the most important action to take during the seizure would be to
A) move any chairs or desks at least 3 feet away from the child
B) note the sequence of movements with the time lapse of the event
C) provide privacy as much as possible to minimize frightening the other children
D) place the hands or a folded blanket under the head of the child
The correct answer is D: place the hands or a folded blanket under the head of the child
The priority during seizure activity is to protect the person from physical injury. Place a pillow, folded blanket or your hands under the child''s head to prevent concussion or other head trauma. The other body parts are at less risk for injury, consequently the prioritized sequence of the actions above would be options D, A, B, and C.
Question Number 8 of 20
A parent calls the hospital hot line and is connected to the triage nurse. The caller proclaims: “I found my child with odd stuff coming from the mouth and an unmarked bottle nearby.” Which of these comments would be the best tool for the nurse to determine if the child has swallowed a corrosive substance?
A) "Ask the child if the mouth is burning or throat pain is present."
B) "Take the child’s pulse at the wrist and see if the child is has trouble breathing lying flat."
C) "What color is the child’s lips and nails and has the child voided today?"
D) "Has the child had vomiting, diarrhea or stomach cramps?"
Your response was "A".
The correct answer is A: "Ask the child if the mouth is burning or throat pain is present."
Local irritation of tissues indicates a corrosive poisoning. The other comments may be helpful in determining the child’s overall condition, however the question concerns evaluation for ingesting a caustic substance.
Which of these actions is the primary nursing intervention designed to limit transmission of a client’s Salmonella infection?
A) Wash hands thoroughly before and after client contact
B) Wear gloves when in contact with body secretions
C) Double glove when in contact with feces or vomitus
D) Wear gloves when disposing of contaminated linens
The correct answer is A: Wash hands thoroughly before and after client contact
Gram-negative bacilli cause Salmonella infection, and lack of sanitation is the primary means of contamination. Two million new cases appear each year. Thorough handwashing can prevent the spread of salmonella. Note that all of the options are appropriate activities, but handwashing is primary.
Question Number 10 of 20
After an explosion at a factory one of the employees approaches the nurse and says “I am an unlicensed assistive personnel (UAP) at the local hospital.” Which of these tasks should the nurse assign first to this worker who wants to help care for the wounded workers?
A) Get temperatures
B) Take blood pressure
C) Palpate pulses
D) Check alertness
The correct answer is C: Palpate pulses
The heart rates would indicate if the client is in shock or has potential for shock. If the pulses could not be palpated, those clients would need to be seen first.
Question Number 11 of 20
A newly admitted adult client has a diagnosis of hepatitis A. The charge nurse should reinforce to the staff members that the most significant routine infection control strategy, in addition to handwashing, is which of these?
A) Place appropriate signs outside and inside the room
B) Use a mask with a shield if there is a risk of fluid splash
C) Wear a gown to change soiled linens from incontinence
D) Have gloves on while handling bedpans with feces
The correct answer is D: Have gloves on while handling bedpans with feces
The specific measure to prevent the spread of hepatitis A is careful handling and protection while working with fecal material. All of the other actions are correct but not the most significant specific approach used with hepatitis A.
Question Number 12 of 20
A nurse is reinforcing teaching with a client about compromised host precautions. The client is receiving filgrastim (Neupogen) for neutropenia. Which lunch selection suggests the client has learned about necessary dietary changes?
A) grilled chicken sandwich and skim milk
B) roast beef, mashed potatoes, and green beans
C) peanut butter sandwich, banana, and iced tea
D) barbeque beef, baked beans, and cole slaw
The correct answer is B: roast beef, mashed potatoes, and green beans
The client has correctly selected an appropriate lunch and appears to know the dietary restrictions. Low granulocyte counts and susceptibility to infection are expected. Compromised host precautions require that foods are either cooked or canned. Options A, C and D do not demonstrate learning, as raw fruits, vegetables, and milk are to be avoided.
Question Number 13 of 20
A client is scheduled to receive an oral solution of radioactive iodine (131I). In order to reduce hazards, the priority information for the nurse to include in client teaching is which of these statements?
A) "In the initial 48 hours, avoid contact with children and pregnant women, and flush the commode twice after urination or defecation."
B) "Use disposable utensils for 2 days and if vomiting occurs within 10 hours of the dose, do so in the toilet and flush it twice."
C) "Your family can use the same bathroom that you use without any special precautions."
D) "Drink plenty of water and empty your bladder often during the initial 3 days of therapy."
The correct answer is A: "In the initial 48 hours, avoid contact with children and pregnant women, and flush the commode twice after urination or defecation."
The client''s urine and saliva are radioactive for 24 hours after ingestion, and vomitus is radioactive for 6 to 8 hours. The client should drink 3 to 4 liters of fluid a day for the initial 48 hours to help remove the (131I) from the body. Staff should limit contact with hospitalized clients to 30 minutes per day per person
Question Number 14 of 20
Which approach is the best way to prevent infections when providing care to clients in the home setting?
A) Handwashing before and after examination of clients
B) Wearing nonpowdered latex-free gloves to examine the client
C) Using a barrier between the client's furniture and the nurse's bag
D) Wearing a mask with a shield during any eye/mouth/nose examination
The correct answer is A: Handwashing before and after examination of clients
Handwashing remains the most effective way to avoid spreading infection. However, too often nurses do not practice good handwashing techniques and do not teach families to do so. Nurses need to wash their hands before and after touching the client and before entering the nursing bag. All of the options are correct, and the sequence of priorities would be options A, C, B, and D.
Question Number 15 of 20
A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which admission orders should the nurse implement first?
A) Institute seizure precautions
B) Monitor neurologic status every hour
C) Place in respiratory/secretion precautions
D) Cefotaxime IV 50 mg/kg/day divided q6h
The correct answer is C: Place in respiratory/secretion precautions
Meningococcal meningitis is a bacterial infection that can be communicated to others. The initial therapeutic management of acute bacterial meningitis includes respiratory/secretions precautions, initiation of antimicrobial therapy, monitoring neurological status along with vital signs, instituting seizure precautions and lastly maintaining optimum hydration. The first action for nurses to take is initiate any necessary precautions to protect themselves and others from possible infection. Viral meningitis usually does not require protective measures of isolation.
Question Number 16 of 20
The nurse is assigned to a client newly diagnosed with active tuberculosis. Which of these interventions would be a priority for the nurse to implement?
A) Have the client cough into a tissue and dispose in a separate bag
B) Instruct the client to cover the mouth with a tissue when coughing
C) Reinforce that everyone should wash their hands before and after entering the room
D) Place client in a negative pressure private room and have all who enter the room use masks with shields
The correct answer is D: Place client in a negative pressure private room and have all who enter the room use masks with shields
A client with active tuberculosis should be hospitalized in a negative pressure room to prevent respiratory droplets from leaving the room when the door is opened. Tuberculosis (TB) is caused by spore-forming mycobacteria, more often Mycobacterium tuberculosis. In developed countries the infection is airborne and is spread by inhalation of infected droplets. In underdeveloped countries, transmission also occurs by ingestion or by skin invasion, particularly when bovine TB is poorly controlled.
Question Number 17 of 20
When an infant car seat is properly installed, the infant should face
A) forward, so child may look out window
B) backward, so child faces the seat
C) the side window, to increase sensory stimulation
D) upward, as child lies on back with seat installed sideways
The correct answer is B: backward, so child faces the seat
Nurses are now responsible for promoting the continued safety of infants and children outside of the hospital. Emergency Department and Women’s Services staff are trained in child seat placement. Growth and development data indicate that infants still require support of the head. Therefore, they should be positioned reclining and facing the rear until their leg muscles are strong enough to kick away from the backseat (about 10-12 months-old) for the greatest protection.
Question Number 18 of 20
Several clients are admitted to an adult medical unit. For which client condition(s) would the nurse institute airborne precautions?
A) Autoimmune deficiency syndrome (AIDS) with cytomegalovirus (CMV)
B) A positive purified protein derivative (PPD) test with an abnormal chest x-ray
C) A tentative diagnosis of viral pneumonia with productive brown sputum
D) Advanced carcinoma of the lung with hemoptysis
The correct answer is B: A positive purified protein derivative (PPD) test with an abnormal chest x-ray
The client who must be placed in airborne precautions is the client with these findings that suggest a suspicious tuberculin lesion. A sputum smear for acid fast bacillus would be done next. CMV usually causes no signs or symptoms in children and adults with healthy immune systems. Good handwashing is recommended for CMV. When signs and symptoms do occur, they are often similar to those of mononucleosis, including sore throat, fever, muscle aches and fatigue.
Question Number 19 of 20
The school nurse is teaching the faculty the most effective methods to prevent the spread of lice (Pediculus Humanus Capitis) in the school. The information that would be most important to include is reflected in which of these statements?
A) "The treatment medication requires reapplication in 8 to 10 days."
B) "Bedding and clothing can be boiled or steamed to kill lice."
C) "Children should not share hats, scarves and combs."
D) "Nit combs are necessary to comb lice eggs (nits) out of children's hair."
The correct answer is C: "Children should not share hats, scarves and combs."
Head lice live only on human beings and can be spread easily by sharing hats, combs, scarves, coats and other items of clothing that touch the hair. All of the options are correct statements, however they do not best answer the question of how to prevent the spread of lice in a school setting.
Question Number 20 of 20
Which of these clients would the nurse recommend keeping in the hospital during an internal disaster at that facility?
A) An adolescent diagnosed with sepsis 7 days ago and whose vital signs are maintained within low normal limits.
B) A middle-aged woman known to have had an uncomplicated myocardial infarction 4 days ago
C) An elderly man admitted 2 days ago with an acute exacerbation of ulcerative colitis
D) A young adult in the second day of treatment for an overdose of acetometaphen
The correct answer is D: A young adult in the second day of treatment for an overdose of acetometaphen
An overdose of Tylenol requires close observation for 3 to 4 days as well as Mucomyst PO during that time . A strong risk of liver failure exists immediately following Tylenol overdose.
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