As part of a major trauma, a patient has suffered a flail chest injury. What hallmark sign of flail chest does the nurse expect to find?
A) Flail segment elevation during inhalation
B) Evidence of rib fractures on chest radiograph
C) Flail segment depression during inhalation
D) Hypoxemia evident on arterial blood gases
C
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A patient with borderline personality disorder cut her wrists while out on a pass. For future planning, staff should consider that the reason for the self-mutilation is probably related to:
a. an inherited disorder that manifests itself as an incapacity to tolerate stress. b. fear of abandonment associated with relationships or increasing autonomy. c. use of projective identification and splitting to bring anxiety to manageable levels. d. a constitutional inability to regulate affect, predisposing to psychic disorganization.
Nursing care after amniocentesis includes:
a. Monitoring uterine activity. b. Placing the client in a supine position for 2 hours. c. Applying a pressure dressing to the puncture site. d. Forcing fluids by mouth.
To establish a mutually respectful relationship with an older adult patient being admitted to a skilled nursing unit, the nurse first introduces himself and then asks
a. how the patient would like to be ad-dressed. b. if the patient has any specific requests to make of the staff. c. the patient to share a little about his or her personal likes and dislikes. d. the patient to read the orientation mate-rials that the facility provides.
A nurse is performing a sterile dressing change. If new sterile items or supplies are needed, how can they be added to the sterile field?
A) with sterile forceps or hands wearing sterile gloves B) by carefully handling them with clean hands C) with clean forceps that touch only the outermost part of the item D) by clean hands wearing clean latex gloves