When considering priority setting of problems, the nurse keeps in mind that second-level priority problems include which of these aspects?
a. Low self-esteem
b. Lack of knowledge
c. Abnormal laboratory values
d. Severely abnormal vital signs
ANS: C
Second-level priority problems are those that require prompt intervention to forestall further deterioration (e.g., mental status change, acute pain, abnormal laboratory values, risks to safety or security)
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For which of the following purposes is a graphic flow sheet superior to other methods of recording data?
1) Easy documentation of routine vital signs 2) Seeing the patterns of a patient's fever 3) Describing the symptoms accompanying a rising temperature 4) Checking to make sure vitals signs were taken
While being interviewed, a patient expresses the belief that other people can place beliefs in her mind. This statement can be assessed as evidence of:
a. thought insertion. b. nihilistic delusions. c. somatic delusions. d. ideas of reference.
When the infant becomes overhydrated, edema becomes obvious in the: (Select all that apply.)
a. Periorbital area b. Occipital area c. Axillary area d. Genital area e. Pedal area
It is not necessary to explain procedures to children who are younger than school age, as they will not understand
Indicate whether the statement is true or false