The nurse determines that further instruction is needed for a patient with interstitial cystitis when the patient says which of the following?
a. "I should stop having coffee and orange juice for breakfast."
b. "I will buy calcium glycerophosphate (Prelief) at the pharmacy."
c. "I will start taking high potency multiple vitamins every morning."
d. "I should call the doctor about increased bladder pain or odorous urine."
ANS: C
High-potency multiple vitamins may irritate the bladder and increase symptoms. The other patient statements indicate good understanding of the teaching.
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A nurse is caring for a client in Buck's skin traction. Which of the following indicates a need for corrective action?
A) The traction weights are touching the floor. B) The traction is being applied continuously. C) The countertraction is opposite to the pull of traction. D) The client's mobility is limited.
The nurse is caring for a client with somatoform disorder. A priority assessment for the nurse to make is to determine if the client is also experiencing symptoms of:
A) Depression. B) Avoidant personality disorder. C) Delirium. D) Bipolar disorder.
Which behavior best demonstrates aggression?
a. Stomping away from the nurses' station, going to the hallway, and grabbing a tray from the meal cart. b. Bursting into tears, leaving the community meeting, and sitting on a bed hugging a pillow and sobbing. c. Telling the primary nurse, "I felt angry when you said I could not have a second helping at lunch." d. Telling the medication nurse, "I am not going to take that, or any other, medication you try to give me."
The nurse is caring for an immunosuppressed 3-year-old girl and is providing teaching to the mother about proper oral hygiene. Which response from the mother indicates a need for further teaching?
A) "I really need to carefully check for skin breakdown." B) "I must really scrub her teeth and gums well." C) "I must use a soft toothbrush." D) "I can use a soft gauze sponge to care for her gums."