5. Which action would best demonstrate evidence-based nursingpractice in the care of a patient who is 1 day postpartum andreporting nipple soreness while breast-feeding? 1. Give the baby a bottle after 5 minutes of nursing to allow soreness to resolve. 2. Assess the mother-baby couplet for nursing position and latch, and correct as indicated. 3. Advise the use of a breast pump until nipple soreness resolves. 4. Advise alternating breast and bottle feedings to avoid excess sucking at the nipple. 5. Ans: 2 It is recommended to avoid artificial nipples and pacifiers while establishing breast feeding unless medically indicated. Improper latch and position are common causes of nipple soreness and can be corrected with assessment and assistance to the mother. This practice supports the Perinatal Core Measure of increasing the percentage of newborns who are fed breast milk only. Focus: Prioritization LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation, and Assignment: Practice Excercises for the NCLEX Exam (p. 199). Elsevier Health Sciences. Kindle Edition. 5. Which tasks are appropriate to delegate to an LPN/ LVN who is functioning under thesupervision of an RN? (Select all that apply.) 1. Assessing the sexual implications for a client with oculogenital-type Chlamydia trachomatis infection 2. Administering sulfacetamide sodium 10% (Sulf-10 Ophthalmic) to a child with conjunctivitis 3. Reviewing hand-washing and hygiene practices with clients who have eye infections 4. Showing clients how to gently cleanse eyelid margins to remove crusting 5. Assessing nutritional factors for a client with age-related macular degeneration 6. Reviewing the health history of a client to identify risk for ocular manifestations 7. Performing a routine check of a client's visual acuity using the Snellen eye chart 5. Ans: 2, 3, 4, 7 Administering medications, reviewing and demonstrating standard procedures, and performing standardized assessments with predictable outcomes in noncomplex cases are within the scope of the LPN/ LVN. Assessing for systemic manifestations and behaviors, risk factors, and nutritional factors is the responsibility of the RN. Focus: Delegation LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation, and Assignment: Practice Excercises for the NCLEX Exam (p. 185). Elsevier Health Sciences. Kindle Edition. 5. You are supervising an RN who floated from the medical-surgicalunit to the emergency department. The nurse is providing care for apatient admitted with anterior epistaxis (nosebleed). Which directionswould you clearly provide to the RN? (Select all that apply.) 1. Position the patient supine and turned on his side. 2. Apply direct lateral pressure to the nose for 5 minutes. 3. Maintain standard body substance precautions. 4. Apply ice or cool compresses to the nose. 5. Instruct the patient not to blow the nose for several hours. 5. Ans: 2, 3, 4, 5 The correct position for a patient with an anterior nosebleed is upright and leaning forward to prevent blood from entering the stomach and to avoid aspiration. All of the other instructions are appropriate according to best practice for emergency care of a patient with an anterior nosebleed.
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