3015 Exam Part 2

The nurse is assessing a group of clients who were brought into the emergency department after a motor vehicle accident that resulted in a fire. Which client should the nurse give the highest priority for care? A 45-year-old man with burns to the upper arms and chest and soot on the face who is restless and anxious A 68-year-old woman with bruises across the chest and lower abdomen who is observed rubbing the bruised area on the lower abdomen and moaning A 4-year-old with a deformed left lower leg with equal pedal pulses in both feet and who is crying loudly An 18-year-old woman sitting up in bed with an egg-size hematoma and a 5-cm laceration on the forehead who is talking rapidly on a cell phone

A 45-year-old man with burns to the upper arms and chest and soot on the face who is restless and anxious

The nurse is providing an educational demonstration to an older, postsurgical client. The intervention is intended to minimize the effect of what age-related change specifically relevant to such a client? (picture - client holding pillow and deep breathing) A decrease in gas exchange and an increase in the work of beathing related to decreased elastic recoil of the lungs A decrease in ventilation and an ineffective cough related less air exchange, more excretions remaining in the lungs A decrease in the ability to respond to stress related to ineffective cardiac muscle function A decrease in cardiac output related to progressive atherosclerosis

A decrease in ventilation and an ineffective cough related less air exchange, more excretions remaining in the lungs

Which situations observed by a nurse should the nurse report to the nurse manager for quality assurance? Select all that apply. A nurse cleans a stethoscope between clients. A nurse assesses a client after sneezing into the nurse's hands. A nurse administers medications to the wrong client. A nurse delays answering call lights to an abusive client. A nurse refuses to provide care to a client with HIV.

A nurse administers medications to the wrong client. A nurse delays answering call lights to an abusive client. A nurse assesses a client after sneezing into the nurse's hands. A nurse refuses to provide care to a client with HIV.

A client who recently became quadriplegic as the result of a motor vehicle accident is experiencing multiple physical and emotional problems. To guide the care planning for this client, what type of nursing diagnosis would be most appropriate for the nurse to select? A problem-focused nursing diagnosis A possible nursing diagnosis A risk nursing diagnosis A syndrome nursing diagnosis

A syndrome nursing diagnosis

A 19-year-old college basketball player is being evaluated for injuries after a skiing accident. The nurse determines that the client has a pulse of 52 beats/min. What would be the most appropriate way for the nurse to determine the significance of the client's heart rate? Ask the client whether the heart rate is normal for the client. Compare the client's heart rate to that another teenaged client. Have another nurse reassess the heart rate for accuracy. Determine whether the client has any risk factors for cardiac disease.

Ask the client whether the heart rate is normal for the client.

The nurse is caring for a client who frequently comes to the emergency department (ED) reporting a headache that is an 8 or 9 on a pain scale of 1 to 10. The client is noted to be laughing while on the phone and chatting with staff after reporting a headache that is a 10. Which action will the nurse perform prior to initiating treatment? Assess for nonverbal cues to pain Contact the pain clinic for further assessment Request a lower dose of medication from the health care provider Discuss observations with the client

Assess for nonverbal cues to pain

A client in the last stages of pancreatic cancer tells the nurse, "I am tired of fighting. I am ready to die." What is the nurse's best action? Collaborate with other disciplines to plan end-of-life care for the client. Research other treatment options available for the client. Remind the client that positive thoughts are essential for recovery. Ask if the client would like to speak with a spiritual adviser.

Collaborate with other disciplines to plan end-of-life care for the client.

The demonstration provided by the nurse is directed at helping the postsurgical client manage what type of pain? (Picture - deep breaths while holding pillow to chest) Splanchnic Deep somatic Neuropathic Superficial

Deep somatic

A client has just given birth to the client's first baby. The client reports to the nurse not knowing very much about newborns because of limited exposure to them. Which is the priority nursing diagnosis for the nurse to address prior to discharge of this client? Fear Deficient Knowledge Alteration in Family Processes Stress Overload Ineffective Coping Mechanisms

Deficient Knowledge

A nurse has developed a plan of care for a client whose spouse recently died. The nurse assigned the client a nursing diagnosis of: Risk for Loneliness. When the nurse is evaluating the plan, the client tells the nurse new information about having an active social life and being satisfied with social activities. What should the nurse do next? Continue with the plan. Delete the nursing diagnosis. Tell the client that the client is lonely. Adjust the time criteria.

Delete the nursing diagnosis.

The nurse is attentive and responsive to the health care needs of individual clients and ensures the continuity of care when leaving these clients. What interpersonal skill is the nurse displaying? Developing technical skills Enjoying the rewards of mutual interchange Developing accountability Developing ethical/legal skills

Developing accountability

The nurse is assessing a client who was just admitted to the unit following an abdominal hysterectomy. On which assessment finding would the nurse base the priority diagnosis? Dressing intact with slight bloody discharge present Client reports being very sleepy Abdominal area soft with diminished bowel sounds throughout Diminished breath sounds in left lower lobe Skin warm and dry

Diminished breath sounds in left lower lobe

The nurse is massaging an older adult client's back and notices a reddened area on the client's sacrum. What actions would the nurse perform in response? Select all that apply. Lightly massage the area. Document the reddened area on the client's medical record. Following the massage, position the client on the sacral area. Report the finding to the primary care provider. Institute a turning schedule. Do not massage the client's back; immediately report the area to the physician.

Document the reddened area on the client's medical record. Report the finding to the primary care provider. Institute a turning schedule.

The nurse is developing a plan of care for a client in acute pain. Which nursing interventions should be included? (Select all that apply.) Encourage deep breathing. Play the client's favorite music. Promote a restful environment. Encourage increased protein. Encourage the use of a sitter.

Encourage deep breathing. Play the client's favorite music. Promote a restful environment

A nurse is developing a plan of care for a client with heart failure brought to the emergency department. The client was experiencing shortness of breath and pitting edema of the lower extremities. Which statement would the nurse identify as a the problem to be addressed in the client's nursing diagnosis? Excess Fluid Volume Heart Failure Shortness of Breath Edema

Excess Fluid Volume

When creating the teaching plan for a client who will be monitoring his or her pulse at home, which factors should the nurse teach the client that may influence the pulse rate by causing an increase in pulse? Select all that apply. Aging Exercise Fever Male gender Stress

Exercise Fever Stress

A nurse is providing care for a client with cancer. The client's spouse requests that the client not be told that the client is terminal. The nurse complies with this request. The nurse's action is a breach of which ethical principle? Autonomy Fidelity Beneficence Nonmaleficence

Fidelity

A nurse is preparing a room for client admission. Which actions follow recommended guidelines for this process? Select all that apply. Always open and position the bed in the highest position. Fold back the top bed linens. Assemble the necessary equipment and supplies, including a hospital admission pack. Do not supply pajamas or hospital gowns until it is determined whether the client will wear the client's own. Ask the physician to assemble special equipment needed by the client (such as oxygen, cardiac monitors, or suction equipment). Adjust the physical environment of the room, including lighting and temperature.

Fold back the top bed linens. Assemble the necessary equipment and supplies, including a hospital admission pack. Adjust the physical environment of the room, including lighting and temperature.

Two nurses will transfer an older adult client from her bed to a chair later in the day. How can the nurses best facilitate a successful transfer? To ensure safety, do not allow the client to assist with the transfer. Use assistive devices if either of the nurses will need to lift more than 60 lb (27.2 kg). If the client is in pain, administer analgesics in advance of the transfer. Avoid using handling aids unless absolutely necessary.

If the client is in pain, administer analgesics in advance of the transfer.

The nurse is preparing a care plan for a client who has recently undergone a mastectomy. Which nursing diagnosis should the nurse rank with the highest priority? Acute pain Knowledge deficit Disturbed body image Impaired tissue integrity

Impaired tissue integrity

A nurse is planning care for an adult client with significant cognitive impairments and a new diagnosis of cancer. What nursing action is most appropriate when establishing the priorities of care? Include the client and the client's power of attorney in the discussion. Ask the client what the priority needs are. Consult the oncology nurse specialist in order to determine priorities. Hold a unit meeting to determine needs.

Include the client and the client's power of attorney in the discussion.

Nurses assess clients who have physiologic responses to pain. Which examples of pain response are physiologic responses? Select all that apply. Exaggerated weeping and restlessness Protecting the painful area Increased blood pressure Muscle tension and rigidity Nausea and vomiting Grimacing and moaning

Increased blood pressure Muscle tension and rigidity Nausea and vomiting

Which nursing interventions would be appropriate for a client diagnosed with deficient fluid volume? Select all that apply . Hypervolemia management Fluid restriction Intravenous therapy Electrolyte management Monitoring edema Nutrition management

Intravenous therapy Electrolyte management Nutrition management

The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy? Limiting visitors due to the client reporting pain Administering pain medication when the pain level reaches 9 on a pain scale of 0 to 10 Changing the channel on the television while providing care Turning and positioning the client every 4 hours

Limiting visitors due to the client reporting pain

A nurse asks a client to rate the pain on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain. Which information will the nurse gather next to establish the client's baseline pain experience? Duration Medications taken Chronology Location

Location

An older adult client assumed care of a parent with dementia and had to decrease work hours to stay and home and care for the parent. Due to the decrease in hours, it is difficult to meet financial obligations. What actions by the nurse would be appropriate for this client? Select all that apply. Make a referral to the case manager to determine available resources. Inform the client that the parent needs to go into a long-term care facility. Have the client make an appointment with social services to assist with financial resources. Suggest the client join a support group for caregivers of parents with dementia. Encourage the client to find another family member to care for the parent.

Make a referral to the case manager to determine available resources. Have the client make an appointment with social services to assist with financial resources. Suggest the client join a support group for caregivers of parents with dementia.

The client has diabetes and an elevated blood glucose level. During the nursing assessment, the client states, "I can't afford the pill used to control my blood sugar." What are appropriate actions by the nurse for this client? Select all that apply. Make a referral to the social worker to find what financial assistance is available for the client. Tell the client, "You have to set priorities, and taking this medication is a financial priority." Consult with the primary care provider about prescribing a medication that is free at some stores. Document the client statement in the assessment record and take no further action. Write a new nursing diagnosis "Noncompliance related to inability to afford treatment."

Make a referral to the social worker to find what financial assistance is available for the client. Consult with the primary care provider about prescribing a medication that is free at some stores. Write a new nursing diagnosis "Noncompliance related to inability to afford treatment."

Two nurses collaborate in assessing an apical-radial pulse on a client. The pulse deficit is 16 beats/min. What does this indicate? The radial pulse is more rapid than the apical pulse. This is a normal finding and should be ignored. The client's arteries are very compliant. Not all of the heartbeats are reaching the periphery.

Not all of the heartbeats are reaching the periphery.

The nurse is caring for a school-age child and notices a variety of circular burns on the back and legs in various stages of healing. What action should the nurse take related to this suspicion? Inform the parent that abuse is suspected. Because the nurse is not sure, observation of the parents behavior will be done. Call the police. Notify the National Abuse Hotline.

Notify the National Abuse Hotline.

The nurse is implementing comfort measures to promote sleep for a client. Which intervention is the best choice for the client? Encourage the client to take a shower prior to bedtime. Have the client set an alarm clock so they are not worried about getting up. Create a warm, dark environment in the clients' rooms. Offer client a small carbohydrate and protein snack before bedtime.

Offer client a small carbohydrate and protein snack before bedtime.

An 18-year-old client is brought to the urgent care clinic reporting severe left leg pain. Which assessment(s) should the nurse prioritize for this client? Select all that apply. (Includes Docucare of normal vitals & leg assessment) Pedal pulses Skin color Temperature of skin Tenderness to palpation Blood pressure

Pedal pulses Skin color Temperature of skin Tenderness to palpation

A nurse identifies an area where client care has been compromised. What steps should the nurse take to improve performance? Select all that apply. Plan a strategy using indicators. Assess the change. Discover a problem. Ask the client if there is a problem. Implement a change.

Plan a strategy using indicators. Assess the change. Discover a problem. Implement a change.

Which are correctly written nursing interventions? Select all that apply. Provide 5 to 6 small meals daily. Reposition the client from side to side every hour around the clock. Provide opportunities for the client to express concerns and verbalize feelings. Understand the side effects of furosemide. Know the signs and symptoms of infection.

Provide 5 to 6 small meals daily. Reposition the client from side to side every hour around the clock. Provide opportunities for the client to express concerns and verbalize feelings.

Which nursing actions reflect the implementing step of the nursing process? Select all that apply. Selecting culturally sensitive nursing interventions Determining the client's response to nursing interventions Providing health education to reduce health risks Referring the client to community resources, when necessary Using evidence-based interventions individualized for the client

Providing health education to reduce health risks Referring the client to community resources, when necessary Using evidence-based interventions individualized for the client

A nurse in the intensive care unit (ICU) has been assigned to care for a client who was seriously injured during a gang rape. The nurse was raped 6 months ago and fears being too upset to care for the client properly. How should the nurse deal with the assignment? Recognize the nurse's own limitations and ask for another nurse to be assigned. Recognize that the nurse may be faced with this issue again and care for the client. Recognize the nurse's own limitations and ask another nurse to assist if the nurse becomes too emotional. Recognize the issue and care for the client to the best of the nurse's ability.

Recognize the nurse's own limitations and ask for another nurse to be assigned.

A nurse is asked to serve on an ethics committee. Which roles would the nurse be required to fill on the committee? Select all that apply. Serving as a liaison between the family and the committee members Making the final decision about end-of-life care Presenting explanations about technical terminology Advocating for the client's wishes Deciding whether mechanical ventilation is appropriate for a client

Serving as a liaison between the family and the committee members Presenting explanations about technical terminology Advocating for the client's wishes

The home health nurse is caring for a noncompliant client who has been diagnosed with type 2 diabetes. Which nursing interventions would be effective in helping the client change behaviors? Select all that apply. Request immediate changes to behaviors. Set short-term goals for modifying eating habits. Encourage participation in a diabetes support group. Include the client in creating a list of benefits for exercising. Provide information taken from textbooks regarding the consequences of diabetes.

Set short-term goals for modifying eating habits. Encourage participation in a diabetes support group. Include the client in creating a list of benefits for exercising.

Which examples are essential components for delegating nursing care to an unlicensed assistive personnel (UAP)? Select all that apply. The UAP has sufficient knowledge and skill for completing the task. The nurse has clearly communicated instructions to the UAP. The UAP can verbalize what information to report to the nurse. The nurse seeks input from the UAP in planning the client's care for the shift. The UAP evaluates the client's response after implementing the task and then reports findings to the nurse.

The UAP has sufficient knowledge and skill for completing the task. The nurse has clearly communicated instructions to the UAP. The UAP can verbalize what information to report to the nurse.

The nurse is responsible for recognizing significant data when developing nursing diagnoses. Which significant data would indicate a health problem may exist? Select all that apply. The client has a blood pressure reading of 150/90 mm Hg. During assessment, the client is sweating and short of breath. The client only answers yes or no questions. The client's urine output of 30 mL per hour is recorded. The client has an oral temperature of 98.7°F (37.0°C).

The client has a blood pressure reading of 150/90 mm Hg. During assessment, the client is sweating and short of breath. The client only answers yes or no questions.

Which client outcome is an example of a physiologic outcome? The client's pulse oximetry reading is 97% on room air 30 minutes after removal of a nasal cannula. The client reports walking for 30 minutes each day. The client demonstrates active range-of-motion exercises with left upper extremity. The client explains how to administer a vaginal cream.

The client's pulse oximetry reading is 97% on room air 30 minutes after removal of a nasal cannula.

The nursing team, consisting of a nurse and experienced unlicensed assistive personnel (UAP), have worked well together for the past year. The nurse instructs the UAP to feed a stable stroke client, assist with dressing a client in preparation for discharge, and take vital signs of a third client in addition to notifying the nurse if the blood pressure becomes low. Which error has the nurse made? The nurse failed to communicate clear instructions regarding what constitutes a low blood pressure. The nurse delegated tasks to the UAP that are outside the scope of that person's preparation. The nurse failed to validate the UAP's knowledge and skill to perform the tasks. The nurse delegated too many tasks to the unlicensed assistive personnel.

The nurse failed to communicate clear instructions regarding what constitutes a low blood pressure.

When performing an assessment on a client with chronic pain, the nurse notes that the client frequently shifts conversational topics. What does the nurse determines that this may be an indicator of? Anxiety Depression Boredom Moodiness

Anxiety

The nurse is educating a client about nonpharmacologic measures to alleviate restless leg syndrome (RLS). Which education points would the nurse include in the plan? Select all that apply. drinking a cup of coffee before bed can help relieve the tingling sensations applying heat or cold to the extremity can help relieve the symptoms an alcoholic drink is recommended before bed to relax the client Biofeedback and TENS can help relax the client and relieve symptoms massaging the legs may relieve symptoms A mild analgesic before bed can help relieve symptoms

Biofeedback and TENS can help relax the client and relieve symptoms massaging the legs may relieve symptoms applying heat or cold to the extremity can help relieve the symptoms

The nurse is providing care for a client who experienced an ischemic stroke 5 days ago. The client now has difficulty swallowing liquids and solids, has weakness on the right side of the body, and is incontinent of bowel and bladder. Which priority nursing diagnoses should the nurse identify and document in the care of this client? Select all that apply. Dysphagia Bowel Incontinence Impaired Swallowing Impaired Physical Mobility Risk for Hemiparesis

Bowel Incontinence Impaired Swallowing Impaired Physical Mobility

While caring for a client recovering from a cerebrovascular accident, the nurse determines that the client would benefit from the services of physical therapy. How should the nurse plan to involve physical therapy in the client's care? By formulating an actual nursing diagnosis By formulating a collaborative problem By formulating a medical diagnosis By formulating orders for physical therapy

By formulating a collaborative problem

Which activities does the nurse engage in during the evaluation phase? Select all that apply. Collects data to determine whether desired outcomes are met Assesses the effectiveness of planned strategies Adjusts the time frame to achieve the desired outcomes Involves the client and family in formulating desired outcomes Initiates activities to achieve the desired outcomes

Collects data to determine whether desired outcomes are met Assesses the effectiveness of planned strategies Adjusts the time frame to achieve the desired outcomes

What verbs should the nurse use to write outcomes that are measurable? Select all that apply. Know Define Hear Verbalize Feel

Define Verbalize

A client with an upper respiratory infection (common cold) tells the nurse, "I am so angry because the nurse practitioner would not give me any antibiotics." What would be the most appropriate response by the nurse? "Antibiotics have no effect on viruses." "Let me talk to the physician and see what we can do." "Why do you think you need an antibiotic?" "I know what you mean; you need an antibiotic."

"Antibiotics have no effect on viruses."

The nurse is assessing a client's postoperative pain. Which statement demonstrates accurate documentation of objective pain assessment? "Client does not appear to be in pain." "Client is smiling and talking with visitors—pain scale not used." "Client seems irritated but states pain is around a level 5." "Client rates pain 4 on a scale of 0 to 10."

"Client rates pain 4 on a scale of 0 to 10."

A client is scheduled to be fitted with a prosthesis following the loss of the nondominant hand after a traumatic injury. Nurses have documented an outcome that states, "After attending multiple educational sessions, the client will demonstrate correct technique for applying the prosthesis." Which statement by the client would indicate a need to revise the plan of care related to this outcome? "I'm not interested in wearing an artificial hand." "People are going to look at me when I wear this thing." "This doesn't look like my other hand." "I don't understand the technology that's used in this artificial hand."

"I'm not interested in wearing an artificial hand."

Before implementing a nursing intervention, which question(s) will the nurse ask oneself? Select all that apply. "Is the client prepared for what needs to be done?" "Do I have all the necessary supplies and equipment needed?" "Do I have the skills to perform the intervention?" "Can I do the intervention alone or do I need help?" "Do any health care provider prescriptions need to be clarified?"

"Is the client prepared for what needs to be done?" "Do I have all the necessary supplies and equipment needed?" "Do I have the skills to perform the intervention?" "Can I do the intervention alone or do I need help?" "Do any health care provider prescriptions need to be clarified?"

A nurse is educating a preoperative client on how to effectively deep breathe. Which instruction would be included? "Make each breath deep enough to move the bottom ribs." "Breathe through the mouth when you inhale and exhale." "Breathe in through the mouth and out through the nose." "Practice deep breathing at least once each week."

"Make each breath deep enough to move the bottom ribs."

Which question would be most helpful to the nurse in facilitating critical thinking during outcome identification and planning? "How do I best cluster these data and cues to identify problems?" "What problems require my immediate attention or that of the team?" "What major defining characteristics are present for a nursing diagnosis?" "How do I document care accurately and legally?"

"What problems require my immediate attention or that of the team?"

When creating a care plan, which is the purpose of identifying the client outcome? To design a plan of care to address the health problem To evaluate the plan of care developed To provide a basis for the scientific rationale To coordinate the nursing intervention

To design a plan of care to address the health problem

The client tells the nurse, "I think the nurse last night may have given me the wrong medication, but I was afraid to say anything." What is the nurse's most appropriate response? "I will report your concerns to the nurse manager." "I will discuss your concerns with the night nurse." "You should always speak up if you have any questions about your care." "You always have the right to refuse any medication or treatment."

"You should always speak up if you have any questions about your care."

Which nurses are acting as an advocate for the client? Select all that apply. The nurse informs the family of a terminally ill client that the client does not want further treatment and wants to go to hospice care. The client is taking oxycodone/acetaminophen for pain and reports the pain is unrelieved. The nurse states, "There is nothing else we can do for your pain." The postoperative client expresses an inability to void in the urinal in bed. The client believes that standing would allow the client to void. The nurse assists the client to a standing position. The primary care provider (PCP) informed the client about needing to have a surgical procedure performed. After the PCP left, the nurse asked the client, "What are you feeling after being told you need surgery?" The stable client is hospitalized on a religious holy day and requests to talk to a minister. The nurse states to the client, "The ministers are too busy to see you today. I'll request the minister to see you tomorrow."

The nurse informs the family of a terminally ill client that the client does not want further treatment and wants to go to hospice care. The postoperative client expresses an inability to void in the urinal in bed. The client believes that standing would allow the client to void. The nurse assists the client to a standing position. The primary care provider (PCP) informed the client about needing to have a surgical procedure performed. After the PCP left, the nurse asked the client, "What are you feeling after being told you need surgery?"

Which error has the nurse made in formulating the nursing diagnosis: Pain related to nurse failing to administer pain med in a timely manner as evidenced by client pain rating of 7 out of 10, client guarding abdominal incision, client ambulating slowly? Used imprecise language Used a medical diagnosis Omitted defining characteristics Used legally inadvisable terms

Used legally inadvisable terms

Which scenario is the best example of the nurse acting as an advocate? Leading implementation of electronic medical records on the unit Writing legislation for insurance coverage for screening colonoscopies Communicating clients' test results to the physician Testing which product is the best for healing diabetic foot ulcers

Writing legislation for insurance coverage for screening colonoscopies

Can a nurse develop a nursing diagnosis when there is not enough evidence to support the presence of a problem, but the nurse would like to gather more evidence? Yes, this defines a risk diagnosis. No, a nursing diagnosis describes an existing problem. No, the nurse must have all of the evidence before formulating the diagnosis. Yes, this defines a possible nursing diagnosis.

Yes, this defines a possible nursing diagnosis.

The nurse working in the community is assigned to the care of several clients. Which client(s) may require assistance to overcome a barriers to accessing adequate care? Select all that apply. student entering a local university a client who is a migrant and works on a farm an older adult client living independently a client who has been unemployed for 6 months an employed woman, pregnant for the second time

a client who is a migrant and works on a farm an older adult client living independently a client who has been unemployed for 6 months

Which client likely faces a risk for the nursing diagnosis of Disturbed Sleep Pattern: Difficulty Remaining Asleep? a client who receives IV antibiotics every 3 hours a client whose opioid analgesics result in central nervous system depression a client who requires blood glucose checks four times daily a client whose physical therapy has been scheduled for 4:30 p.m.

a client who receives IV antibiotics every 3 hours

A nurse sees the client grimace and documents that the client is in pain, without interviewing the client to obtain further cues. The nurse has: an impaired cluster interpretation. a lack of cues, or premature closure. an ineffective database. an inaccurate evaluation.

a lack of cues, or premature closure.

When collecting subjective and objective data for a database in a client's home, it is important to: ask the client to turn off the television. ask the social worker to verify the collected data. collect a 24-hour diet recall. evaluate the care provided by the physician.

ask the client to turn off the television.

The nurse is caring for a client with terminal bone cancer. The client states, "My pain is getting worse and worse, and the morphine doesn't help anymore." The nurse determines the client's pain is: acute. chronic malignant. diffuse. intractable.

chronic malignant.

Which client would benefit from a PRN drug regimen? client who had thoracic surgery 12 hours ago client who had thoracic surgery 4 days ago client who has intractable pain client who has chronic pain

client who had thoracic surgery 4 days ago

The nurse is informed while receiving a nursing report that the client has been hypoxic during the evening shift. Which assessment finding is consistent with hypoxia? confusion decreased blood pressure decreased respiratory rate hyperactivity

confusion

Two children need a kidney transplant. One is the child of a famous sports figure, whereas the other child comes from a low-income family. What ethical consideration is relevant to the nurse as an advocate for these clients? the relationships between clinicians and patients norms of family life considerations of power cost-effectiveness and allocation

cost-effectiveness and allocation

A nurse is educating a client on meditation techniques to provide mental calmness and physical relaxation. Which nursing intervention facilitates this process? helping the client to assume a specific, comfortable posture providing a stimulating environment in which to conduct the meditation teaching the client to have multiple focal points promoting a closed attitude to avoid judgments and distractions

helping the client to assume a specific, comfortable posture

To drain the apical sections of the upper lobes of the lungs, the nurse should place the client in which position? left side with a pillow under the chest wall side-lying position, half on the abdomen and half on the side high-Fowler's position Trendelenburg position

high-Fowler's position