A client is scheduled to have a tumor of the middle ear removed. What teaching topic is most important for the nurse to cover?
a. Expecting hearing loss in the affected ear
b. Managing postoperative pain
c. Maintaining NPO status prior to surgery
d. Understanding which medications are allowed the day of surgery
ANS: A
Removal of an inner ear tumor will likely destroy hearing in the affected ear. The other teaching topics are appropriate for any surgical client.
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The patient's serum creatinine level is 0.7 mg/dL. The expected BUN level should be:
a. 1-2 mg/dL. b. 7-14 mg/dL. c. 10-20 mg/dL. d. 20-30 mg/dL.
The patient tells the home health nurse that he has flung himself out of bed three times in the course of a violent nightmare. What sleep disorder does the nurse suspect?
a. Myoclonus b. Restless legs syndrome c. Rapid eye movement (REM) sleep disorder d. Epilepsy
A client is scheduled for an ECG single-photon emission-computed tomography (SPECT). She asks why they are doing this test. The nurse explains that: Select all that apply
1. SPECT images display three views of the heart instead of on a single plane. 2. SPECT images are high resolution and have better separation of overlapping myocardial segments, which provides more specific information about cardiac muscle function. 3. SPECT images can be correlated with the ECG to assess ventricular wall motion, which assesses the effectiveness of the heart muscle. 4. SPECT is an accurate depiction of the electrical activity of the heart. 5. SPECT gives specific information about percent of coronary artery occlusion.
A nurse is providing nursing care to patients after completing a care plan from nursing diagnoses. In which step of the nursing process is the nurse?
a. Assessment b. Planning c. Implementation d. Evaluation