Throughout the assessment, the client displays disorganized thinking, jumping from one idea to another with no clear relationship between the thoughts. The nurse would assess the client as having which of the following?
A) Concrete thoughts
B) Ideas of reference
C) Loose associations
D) Word salad
C
Feedback: The client displayed ideas that were loosely associated to one another. Concrete thoughts occur when the client continually gives literal translations. Ideas of reference are the client's inaccurate interpretation that general events are personally directed to him or her. Word salad is a flow of unconnected words that convey no meaning to the listener.
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The home care nurse is using OASIS information to evaluate outcome measurements for client care. Which data should the nurse use for this evaluation?
1. Client's Braden Skin Assessment score is 12. 2. Client has a stage 2 pressure ulcer on the sacrum. 3. Client admission paperwork completed within 24 hours. 4. Client self-administers insulin and changes foot wound dressing independently.
The physician writes an order for a client to receive 1 mg of vitamin B12 once every month. Vitamin B12 comes in a 1000-mcg/mL vial
The nurse would administer _______ mL to the client each month.
The __________ includes all the information obtained from the medical and nursing history, physical examination, and diagnostic studies
Fill in the blank(s) with correct word
Which finding should the nurse anticipate in an infant with coarctation of the aorta?A) Higher right ventricular pressure than left ventricular pressure B) Lower blood pressure in the lower extremities than the upper extremities C) Higher blood pressure in the upper extremities than the lower extremities D) Higher blood pressure in the left arm tan the right arm
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