A 68-year-old client with end-stage renal disease (ESRD) arrives at the outpatient dialysis center for a scheduled hemodialysis session. The RN is the only registered nurse on the unit and is responsible for overseeing care for several clients. A certified dialysis technician (CDT) is available to assist with patient care. The RN is determining which tasks can be appropriately delegated. Which task is most appropriate for the RN to delegate to the certified dialysis technician?

A 35-year-old client with a 5-year history of relapsing-remitting multiple sclerosis (MS) is admitted to the medical unit with new-onset lower extremity weakness, difficulty walking, and blurred vision in the right eye. The client states, “This feels like the flare I had two years ago, only worse.” The nurse prepares a care plan to address both the acute exacerbation and the long-term management of the client’s MS. Drag each nursing intervention to the appropriate category of MS care.

A charge nurse in a tertiary care facility is reviewing four clients with renal involvement to determine which one is the most appropriate candidate for continuous renal replacement therapy (CRRT) rather than intermittent hemodialysis. Which client is the most appropriate candidate for continuous renal replacement therapy (CRRT)?

A 70-kg client with septic shock secondary to urosepsis has been receiving aggressive treatment in the ICU for the past hour, including: 30 mL/kg of IV lactated Ringer’s per the Surviving Sepsis Campaign bundle Broad-spectrum IV antibiotics (piperacillin-tazobactam) A norepinephrine infusion titrated to maintain MAP ≥ 65 mm Hg Admission values (1 hour ago): MAP: 58 mm Hg HR: 128 bpm Serum lactate: 4.8 mmol/L Urine output: 15 mL/hr Skin: mottled, cap refill > 4 sec The nurse is reviewing the chart to evaluate the client’s response to treatment. Which documented change best indicates that the client’s condition is improving?

A 34-year-old client with a T4 spinal cord injury sustained 8 months ago is receiving care on a medical unit after being admitted for a urinary tract infection. The client performs clean intermittent self-catheterization every 6 hours at home but has not catheterized in 8 hours due to nausea and fatigue. The client calls the nurse using the call light and reports: “I have a pounding headache, I can’t see right, and my chest feels tight.” Assessment findings: BP: 204/112 mm Hg (baseline 108/68) HR: 52 bpm, regular RR: 20 SpO₂: 96% on room air Skin above the level of injury: flushed, warm, and diaphoretic Skin below the level of injury: pale, cool, with piloerection (“goosebumps”) Client reports blurred vision and nasal congestion Indwelling Foley is not in place; abdomen is palpably distended over the bladder Last bowel movement: 3 days ago What is the nurse’s priority action?

A 67-year-old client presents to the neurology clinic with a 6-month history of progressive hand tremor at rest, stiffness, slowed movement, and a shuffling gait. On examination, the provider notes a pill-rolling tremor of the right hand, cogwheel rigidity, bradykinesia, and a masked facial expression. The provider suspects Parkinson’s disease (PD). The nurse is reviewing the underlying pathophysiology and expected diagnostic findings with the client. Which diagnostic or pathophysiologic finding supports the diagnosis of Parkinson’s disease?

A 72-year-old outpatient client with chronic heart failure with reduced ejection fraction (HFrEF, EF 32%) returns to the cardiology clinic after 2 weeks of therapy with metoprolol succinate (Toprol XL) 25 mg PO daily. The client was initiated on the medication at the last visit as part of guideline-directed medical therapy for HF. Current assessment findings: BP: 88/42 mm Hg (baseline 128/76) HR: 59 bpm, regular RR: 18 SpO₂: 96% on room air Lungs: clear to auscultation 2+ pitting pedal edema bilaterally (was 3+ at initiation) Weight: 1.8 kg decrease over 2 weeks Client reports improved exercise tolerance but has had two episodes of mild dizziness when rising from a chair this week Which assessment finding is most important for the nurse to report to the healthcare provider?

A nurse is precepting a new graduate in the ICU and is reviewing the five major categories of shock. The nurse explains that each shock state has a distinct hemodynamic and clinical profile driven by its underlying mechanism, and that recognizing these patterns is essential for selecting appropriate interventions. Match each type of shock to its most characteristic clinical feature.

A 30-year-old client presents to the neurology clinic for evaluation of symptoms that have developed over the past several weeks: Blurred vision in the right eye with pain on eye movement Numbness and tingling in both legs Unilateral weakness in the left arm Persistent fatigue that worsens in the afternoon Difficulty concentrating at work The provider orders a brain and spinal cord MRI and suspects multiple sclerosis (MS). The nurse is reviewing the expected clinical picture with the client. Based on the underlying disease process of MS, which additional cluster of findings should the nurse expect?

A 72-year-old client is brought to the emergency department by family after vomiting bright red blood and passing melena stools over the past several hours. The client has a history of peptic ulcer disease and chronic NSAID use for osteoarthritis. Assessment findings: BP: 78/48 mm Hg (MAP 58) HR: 132 bpm, sinus tachycardia, thready radial pulse CVP: 2 mmHg RR: 26/min, shallow SpO₂: 93% on room air Skin: pale, cool, diaphoretic Capillary refill: > 3 seconds Mental status: anxious, mildly confused Neck veins: flat The provider suspects hypovolemic shock from the acute GI bleed. Which clinical finding best supports the diagnosis of hypovolemic shock?