Explaining a paracentesis to an anxious client, the nurse states that the purpose is to
a. collect fluid accumulations from the pleura.
b. evaluate secretions of the gallbladder.
c. extract fluid sequestered in the pancreas.
d. remove excess fluid from the peritoneum.
D
Paracentesis (peritoneal tap) is used to extract fluid accumulation in the peritoneum (ascites); relieve intra-abdominal tension, which can impair the client's respiratory status; or obtain fluid for culture.
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A 30-year-old male patient has been ordered Demerol 75 mg IM every 4 hours after a fractured femur. What action should the nurse take?
A) Give the medication as ordered. B) Administer half the dose. C) Call the physician for a smaller dose. D) Give the dose by mouth.
The nurse is working with a female client who has just arrived in this country from the Philippine Islands and speaks no English. There is a male nurse working on the unit from the Philippines
Which of the following questions will the nurse need to ask to reduce communication barriers? Select all that apply. Standard Text: Select all that apply. 1. Is the male nurse willing to help in this situation? 2. Does the client speak Castilian Spanish or ordinary Spanish? 3. Would a male nurse providing care concern the client? 4. Do the client and male nurse speak the same dialect? 5. Do the client and male nurse come from the same island?
The nurse notices that a client's pupils constrict when reading the consent form for medical treatment. Based on this data, which should the nurse consider as the cause?
1. The room is too dark. 2. The client is able to read. 3. This is a normal response. 4. The client requires glasses for reading.
Which intervention is most likely to achieve the expected outcome of preventing deteriora-tion in neurologic status in a client with a vertebral fracture?
A. Reorient the client to time, place, and person, as needed. B. Administer the Mini-Mental Status Examination. C. Immobilize the affected portion of the spinal column. D. Reposition the client every 2 hours.