A patient arrives in the PACU. Which action does the nurse perform first?
a. Assess for a patent airway and adequate gas exchange
b. Rate the patient's pain using the 0-10 pain assessment scale
c. Position the patient in a supine position to prevent aspiration
d. Calculate the patient-controlled analgesia (PCA) pump maximum dose per hour to avoid an overdose
Answer: a. Assess for a patent airway and adequate gas exchange
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A non-Spanish-speaking nurse is working with a seven-year-old client who is able to speak English but whose family speaks only Spanish. The nurse needs to give discharge instructions regarding the client's oral antibiotics
There are no Spanish-speaking interpreters available presently, but one will be able to come in about one hour. The nurse's most appropriate intervention would be: 1. To give the discharge instructions to the parents, with the child acting as interpreter. 2. To give the discharge instructions to the child. 3. To obtain an English/Spanish translation book and use this to aid in giving discharge instructions to the parents. 4. To have the parents wait until an interpreter can be found to translate the discharge instructions.
The nurse is caring for a client who has difficulty making decisions, frequently saying "I'm so stupid. What do you think I should do?" The client's actions lead the nurse to suspect the possibility of what personality disorder?
1. Paranoid 2. Schizoid 3. Dependent 4. Avoidant
While the nurse is obtaining a drug history from a patient, the patient tells the nurse that he is allergic to penicillins and has also experienced a rash when he took a cephalosporin
The nurse interprets this information as indicating which of the following? A) Hypersensitivity B) Cross-sensitivity C) Anaphylactoid reaction D) Anaphylaxis
The nurse is teaching patients in a senior center about complementary and alternative therapies. Which statement by a patient indicates understanding of the information the nurse has presented? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply
1. "I see now that ‘natural' doesn't really mean ‘safe,' and I should ask my health care provider about any supplements I want to take." 2. "I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my doctor." 3. "I understand now that when I choose to use a natural product over a prescription medication, I could be delaying my recovery." 4. "It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective therapy." 5. "I'm allergic to many foods. It's good to know that because herbal products are natural, I don't have to worry about an allergic reaction."