A critically ill patient has an elevated platelet count. What potential complication does the nurse assess for?
A) Dehydration
B) Thrombosis
C) Hepatic impairment
D) Disseminated intravascular coagulation
B
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A change in nursing care delivery system is being considered by hospital administrators. Which information should the nurse executive add to this discussion?
1. "There has been little change in nursing care delivery over the last few years." 2. "We must look to the nursing process for guidance in nursing care." 3. "Too much time is spent deciding on a system of care." 4. "Any system is okay, as long as the nurses follow it."
A client has exhibited repeated return of hordeolum (sty). Which assessment finding is most important in determining care for this client?
A) Use of mascara B) Low blood sugar C) Use of disposable wash cloths D) Antibacterial facial wash
The nurse is evaluating a new mother's ability to breastfeed her infant. Which criteria indicate that the mother is able to breastfeed independently? (Select all that apply.)
A) Nipples are everted. B) Breasts are soft and nontender. C) Mother holds the nipple in the baby's mouth. D) Baby swallows spontaneously and frequently. E) Nurse places pillows under the baby for support.
Which assessment finding presents the greatest risk for violent behavior directed at others?
a. Severe agoraphobia b. History of spousal abuse c. Bizarre somatic delusions d. Verbalized hopelessness and powerlessness