A client with delirium is attempting to remove the intravenous tubing from his arm, saying to the nurse, "Get off me! Go away!" The client is experiencing which of the following?
a. Delusions
b. Hallucinations
c. Illusions
d. Disorientation
Ans: b. Hallucinations
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The nurse is performing an eye-screening clinic at a daycare center. When examining a 2-year-old child, the nurse suspects that the child has a "lazy eye" and should:
a. Examine the external structures of the eye. b. Assess visual acuity with the Snellen eye chart. c. Assess the child's visual fields with the confrontation test. d. Test for strabismus by performing the corneal light reflex test.
During an admission assessment, the patient informs the nurse that he smokes one and a half packs of cigarettes a day. The nurse is aware that the patient is at an increased risk of developing which of the following diseases?
A) Emphysema B) Depression C) Alcoholism D) Obesity
Once an order has been transcribed to the MAR
A. the registered nurse verifies that the order is transcribed correctly. B. the medication can be given to the patient with no further actions. C. the physician will verify the correctness of the order. D. the medication technician verifies the correctness of the order.
A patient is receiving continuous enteral nutrition through a small-bore silicone feeding tube. What should the nurse plan for when this patient has a computed tomography (CT) scan ordered?
a. Shut the feeding off 30 to 60 minutes before the scan. b. Ask the health care provider to reschedule the CT scan. c. Connect the feeding tube to continuous suction during the scan. d. Send the patient to CT scan with oral suction in case of aspiration.