A client at 37 weeks' gestation presents with painless vaginal bleeding and no contractions. The nurse suspects this client has:
A) placental abruption. B) ectopic pregnancy. C) placenta previa. D) preterm labor.
C
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The nurse working in the long-term care facility reviews a physician order that the nurse feels is unsafe. The physician is contacted and upholds the order. What should the nurse do?
1. Carry out the order and document the order was questioned with the physician. 2. Refuse to carry out the order and document the rationale for why it was not done. 3. Consult the RN supervisor and explain the situation and the physician's response. 4. Explain the dilemma to the patient and ask the patient to give permission for the order to be done.
The nurse is caring for a patient with a diagnosis of pulmonary embolism. The nurse understands that the most common cause of a pulmonary embolus is:
a. amniotic fluid embolus. b. deep vein thrombosis from lower extremities. c. fat embolus from a long bone fracture. d. vegetation that dislodges from an infected central venous catheter.
In a class for new parents, what information should the nurse include about the fontanelles in the newborn infant?
A. "There are three fontanelles, or ‘soft spots,' on the infant's head." B. "Notify the physician if you notice bulging of the fontanelle when the infant cries." C. "Avoid touching the skin over the fontanelles because the infant's brain could be damaged." D. "The posterior fontanelle closes in 2 to 3 months; the anterior fontanelle in about 18 months."
While assessing a patient who has an arterial catheter in place, the patient complains of numbness and tingling in the fingers. Which of the following would be the most important for the nurse to determine?
1. a pulse is palpable 2. blood is easily obtained from the catheter 3. the system is calibrated 4. the waveform has a characteristic appearance