A registered nurse was pulled from her normal unit to fill in for a pediatric unit. She is caring for a 16-year-old patient who refuses to cooperate for a dressing change
The nurse tells the patient that she will tie the patient down if she does not hold still. This threat is an example of which of the following? A. Assault
B. Unintentional tort
C. Battery
D. Felony
A
Assault is an intentional threat toward another person that gives that person a reasonable fear of harmful contact. No actual contact is required for an assault to occur. An example of an assault in nursing practice is to threaten to restrain a patient for an x-ray procedure when the patient has refused consent.
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During report, the nurse is told that a patient "has moderate jaundice." Which of the following assessment findings would the nurse expect to see?
a. Bluish tinge to the fingers and toes b. Flushing in the face c. Yellow discoloration of the skin d. Pale mucous membranes
A client is admitted to the emergency department with toxic shock syndrome. Which action by the nurse is the most important?
a. Administer IV fluids to maintain fluid and electrolyte balance. b. Remove the tampon as the source of infection. c. Collect a blood specimen for culture and sensitivity. d. Transfuse the client to manage low blood count.
Which of the following clinical manifestations is usually the first symptom of peripheral arterial disease (PAD)?
a. Cramping when walking c. Pulmonary embolism b. Thrombophlebitis d. Cordlike veins
The case manager has the option to refer a client with severe mental illness to a vocational
rehabilitation program. Which model, supported by evidence, should the nurse choose for the client? a. Referral to a state vocational rehabilitation agency for prevocational training b. Referral to a sheltered workshop with later placement in a competitive job c. Job placement followed by individualized, on-the-job training d. Cognitive interventions alternating with job skill training