Which one of the following sets of assessment data is most likely to be present with the nursing diagnosis Risk for infection?
1. fever, dysuria, change in urine concentration, and urinary urgency
2. abdominal pain, sore mouth, hyperactive bowel sounds, and leukopenia
3. fatigue, electrocardiographic changes, dependent edema, and activity intolerance
4. abdominal incision, decreased hemoglobin, and indwelling catheter present
ANS: 4
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A patient with increased intracranial pressure is prescribed mannitol (Osmitrol). What should the nurse do when providing this medication?
Select all that apply. 1. Use an in-line filter for IV administration. 2. Do not administer the medication if crystals are noted in the solution. 3. Monitor central venous pressure (CVP) and pulmonary artery pressures (PAP) before and every hour throughout administration. 4. Assess patient for signs of fluid retention. 5. Discontinue the drug immediately if the patient complains of a headache.
The PR interval of a first-degree AV block _____
a. is constant and less than 0.12 seconds in duration b. is constant and more than 0.20 seconds in duration c. is generally progressive until a P wave appears without a QRS complex d. gradually decreases in duration until a P wave appears without a QRS complex
In Watson's conceptual model, nursing is a caring art and science and caring is a(n) _____ ideal
a. ethical c. philosophical b. moral d. theoretical
A client is prescribed a noncardioselective beta1 blocker. What nursing intervention is a priority for this client?
a. Assessment of blood glucose levels b. Respiratory assessment c. Orthostatic blood pressure assessment d. Teaching about potential tachycardia