For which client condition would the nurse most likely expect a capillary refill time longer than 2 seconds?
A) Inflammatory bowel disease
B) Multiple sclerosis
C) Malignant melanoma
D) Peripheral vascular disease
D
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A client with acquired immune deficiency syndrome and esophagitis due to Candida fungus is scheduled for an endoscopy. What actions by the nurse are most appropriate? (Select all that apply.)
a. Assess the client's mouth and throat. b. Determine if the client has a stiff neck. c. Ensure that the consent form is on the chart. d. Maintain NPO status as prescribed. e. Percuss the client's abdomen.
A nurse is caring for a school-age client who is scheduled to have a tonsillectomy the next day. The nurse has planned a preoperative teaching session for the child, who has a history of attention-deficit/hyperactivity disorder (ADHD)
Which teaching technique is most appropriate for this client? A) Play a television show in the background. B) Ask other children who have had this procedure to talk to the child. C) Allow the child to lead the session to gain a sense of control. D) Give instructions verbally and use a picture pamphlet, repeating points more than once.
The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?
a. Postpone starting the IV until the next shift. b. Start the IV line and then allow for expression of feelings. c. Change the route of the antibiotics to PO. d. Postpone starting the IV line until the child is ready.
A nurse is caring for a client who questions how mental health and mental illness are defined. Which words should the nurse use to describe the concepts of mental health and mental illness?
A) Rigid and existential B) Multidimensional and culturally defined C) Universal and unchanging D) Unidimensional and fixed