To assess hepatojugular reflux in a patient with heart failure, the nurse should:
A) Elevate the patient's head to 90 degrees.
B) Press the right upper abdomen.
C) Press the left upper abdomen.
D) Lay the patient flat in bed.
Ans: B
Feedback: Hepatojugular reflux, a sign of right-sided heart failure, is assessed with the head of
the bed at a 45-degree angle. As the right upper abdomen (the area over the liver) is compressed for 30 to 40 seconds, the nurse observes the internal jugular vein. If the internal jugular vein becomes distended, a patient has positive hepatojugular reflux.
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A health care organization has provided intensive education to staff regarding benefits and correct methods of delegation
Why has the organization spent the time and money to sponsor these sessions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Good delegation helps to reduce overtime. 2. Absences decrease when delegation is used correctly. 3. Delegation is required by state boards of nursing. 4. Patient satisfaction scores increase when care is efficient and effective. 5. Good delegation increases productivity.
While evaluating a patient's pulmonary artery waveforms, the nurse notes a sudden onset of right ventricular waves. Which nursing intervention is indicated?
1. Assist the patient to a left side-lying position. 2. Notify the physician for repositioning. 3. Increase intravenous fluids. 4. Nothing, since this is an expected occurrence.
Which of the following would be considered a criminal action?
a. A nurse who steals narcotics from the hospital b. A nurse who gets into a verbal disagree-ment with a visitor c. A nurse who restrains a patient who is considered a threat to himself d. A nurse who refuses to allow a visitor onto the unit who appears intoxicated
Most deaths to women around the world are related to
a. Diarrheal and respiratory infections b. Malnutrition c. Pregnancy and childbirth d. Tuberculosis