Which of these patients being seen at the human immunodeficiency virus (HIV) clinic should the nurse assess first?
a. Patient whose latest CD4+ count is 250/µL
b. Patient whose rapid HIV-antibody test is positive
c. Patient who has had 10 liquid stools in the last 24 hours
d. Patient who has nausea from prescribed antiretroviral drugs
ANS: C
The nurse should assess the patient for dehydration and hypovolemia. The other patients also will require assessment and possible interventions, but do not require immediate action to prevent complications such as hypovolemia and shock.
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Which tasks can the nurse assign to the unlicensed assistive personnel (UAP) who is assisting with providing care on a medical-surgical unit?
Select all that apply. 1. Documenting the assessment completed by the nurse 2. Reinforcing teaching previously provided by the nurse 3. Assisting with client exercises 4. Reporting when a client cannot complete exercises 5. Conducting discharge teaching
An obese adult requests dexfenfluramine for obesity after reading about the drug online. The nurse should provide which information?
a. This drug has been approved for long-term weight control. b. This drug is indicated only for obese patients with hypertension or heart disease. c. This drug was removed from the market because of associated heart damage. d. This drug may help with weight loss, but diet management should be used first.
A client is prescribed alprazolam (Xanax) for acute anxiety. What client history should cause a nurse to question this order?
A. History of alcohol dependence B. History of personality disorder C. History of schizophrenia D. History of hypertension
A man had been attending Alcoholics Anonymous (AA) meetings. Following an argument with his former wife over appropriate child care arrangements and need for financial support, he stopped by his favorite tavern
On the basis of what he had been taught at AA, what should he conclude? a. He had made a horrible mistake and inpatient therapy was now his only option. b. He needs to see a therapist to understand why, when he had been doing so well, he voluntarily entered that tavern. c. He was a miserable failure doomed to be an alcoholic forever. d. Relapses are common in early recovery; he should go back to AA and try again.