The nurse is caring for a patient admitted with a history of hypertension (HTN). The patient's medication history includes Hydrochlorothiazide for the past 10 years. Which parameter would indicate the optimal intended effect of this medication?
a. Absence of ankle edema.
b. Blood pressure 116/70.
c. Output of 600 mL per 8 hours.
d. Weight loss of 2 lbs.
b. Blood pressure 116/70.
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An intervention for a patient with learned helplessness is to
a. maintain control of the environment. b. set limits on the behavior. c. maintain a routine schedule so that the patient can anticipate activities. d. prepare the patient for transfer to the medical floor.
A client tells the nurse that he believes he is not just religious but also spiritual even though he participates in religious rituals. The client is describing which characteristic of spirituality?
a. Relationship with the self b. Relationship with a higher power c. Harmony with nature d. Relationship with others
The nurse assists the client to a sitting position on the side of the bed. Place the nursing interventions in order beginning with the initial nursing action
1. Drop client's legs over side of bed to sit up. 2. Roll client onto one side with flexed knees. 3. Place the client's bed in the lowest position. 4. Raise head of client's bed to upright position.
A person's catheter is accidentally disconnected from the drainage tubing. What should you do?
a. Reconnect the ends after wiping them with antiseptic wipes. b. Put the ends down. Call for the nurse. c. Get a new drainage bag. d. Change the drainage system.