The Charge nurse observes a fellow staff nurse acting erratically.  The clients assigned to the staff nurse don’t seem to get the relief when pain medications are administered. Which action will the charge nurse take?

The nurse is caring for a client with multiple sclerosis.  The client has a stage II pressure ulcer on the sacrum.  Which intervention will the nurse delegate to the unlicensed assistive personnel (UAP)?

During an acute phase of Guillian-Barre´ Syndrome, what is the priority nursing assessment?

A bolus of mannitol (Osmitrol) is ordered for a client with increased intracranial pressure.  Prior to administration, the urinary output is 40 ml/hr; apical pulse 88; PEARL @3mm; the client is drowsy, but easily aroused.  Which assessment data will best determine the therapeutic effect of the medication?

In the acute phase of seizure activity, the nurse anticipates the order for which of the following emergency medications?

A client who has been treated for status epilepticus in the emergency department will be transferred to the medical unit.  What equipment will the nurse have available in the client’s assigned room?  Select ALL that apply.

What assessment data is appropriate to document in the clients electronic health record when utilizing the Glasgow Coma Scale to complete the neurological assessment?  Select ALL that apply.

Which assessment most accurately determine a late sign of increased intracranial pressure?

The nurse is observing a client with cerebral edema for evidence of increasing intracranial pressure (IICP) and monitoring for the development of a widening pulse pressure. The current blood pressure is 170/80. What is the client’s pulse pressure? Please record your answer using a whole number.

A client has impacted cerumen in the left ear. Which of the following is appropriate to use to help dislodge the cerumen? Select all that apply.