Which beverage available on the unit should the nurse select for a between-meal supplement for a
depressed client with a nursing diagnosis of imbalanced nutrition: less than body requirements when
the client refuses solid food?
a. Tomato juice
b. Orange juice
c. Hot tea
d. Milk
D
Milk is the only beverage listed that provides protein, fat, and carbohydrates. In addition, milk is
fortified with vitamins.
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A patient is admitted to the hospital for cardiac surgery and has just come up to the postsurgical unit from the recovery room. He develops unprecedented confusion and states, "I see bugs up and down the walls. They are going to get me
" The nurse suspects the patient is suffering from what symptom? A) Depression B) Delusions C) Delirium D) Schizophrenia
On an electrocardiogram, you see a deepened Q wave that is greater than one-third the height of the QRS complex. This is indicative of:
A. Acute myocardial infarction B. Acute myocardial ischemia C. Left ventricular hypertrophy D. Past myocardial infarction
Nonreassuring fetal status often occurs with a tachysystole contraction pattern
Intrauterine resuscitation measures may become warranted and can include which of the following measures? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Position the woman on her right side. 2. Apply oxygen via face mask. 3. Call for anesthesia provider for support. 4. Increase intravenous fluids by at least 700 mL bolus. 5. Call the physician/CNM to the bedside.
A nurse is preparing to administer RhoGam to a client who delivered a fetal demise. Which of the following must the nurse check before giving the injection?
a. Verify that the direct Coombs test results are positive. b. Check that the fetus was at least 28 weeks' gestation. c. Make sure that the client is at least 3 days postdelivery. d. Confirm that the client is Rh negative.