The nurse notes an elevated jugular venous pressure (JVP). Which disease process can cause this assessment finding?
1) Hypovolemia
2) Constrictive pericarditis
3) Right ventricular hypertrophy
4) Abnormal venous wave forms
ANS: 2
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The nurse should implement which interventions for an infant experiencing apnea? Select all that apply
a. Stimulate the infant by gently tapping the foot. b. Shake the infant vigorously. c. Have resuscitative equipment available. d. Suction the infant. e. Maintain a neutral thermal environment.
A nurse is planning care for an autistic child. Which is a positive and realistic outcome for this client?
A) The client communicates his or her needs verbally. B) The client participates with peers in a team sport. C) The client has established trust with at least one caregiver. D) The client performs all self-care tasks independently.
A young client has been diagnosed with a soft tissue tumor resembling striated muscle in the neck. The nurse realizes that this type of tumor would be considered:
1. chondrosarcoma. 2. Ewing's sarcoma. 3. neurofibrosarcoma. 4. rhabdomyosarcoma.
The nurse is interviewing the caregiver of a 5-year-old child who has been admitted with bruises on the abdomen and thighs, as well as additional bruises in various stages of healing
Which of the following statements made by the caregiver might alert the health care team to the possibility of child abuse? A) "His brother just plays too rough with him." B) "My child goes to daycare after school." C) "He just learned to ride his bicycle." D) "When he is in trouble I make him go to his room."