A patient is diagnosed with epicarditis. What should the nurse recall regarding the purpose of the epicardium when caring for this patient?
a. Line the chambers of the heart.
b. Line the coronary blood vessels.
c. Cover the heart muscle and prevent friction.
d. Contract and pump blood from the ventricles.
ANS: C
The epicardium covers the heart muscle and prevents friction for efficient function. A. B. D. The epicardium does not line the heart chambers or the coronary vessels and does not contract and pump blood from the ventricles.
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A client is recovering from a leg amputation and is doing well. However, the nurse still cautions the client to
a. avoid any trips with the new prosthesis in the next year or so. b. call for help when getting out of bed. c. limit pain medication to prevent dizziness at therapy. d. not be too excited about progress until fitted with the prosthesis.
The nurse cautions that the OVR test should not be used when assessing a client who exhibits
a. hypotension. b. irregular respirations. c. otorrhea. d. vomiting.
The nurse understands that histamine, a naturally occurring substance in the body that is released in response to tissue damage, causes all the following symptoms except:
a. it dilates the arterioles to allow increased blood supply to the area. b. gastrointestinal upset. c. increased mucus production. d. itching.
The nurse is caring for a client with a newly created ostomy. After changing the ostomy appliance, which items should the nurse include when documenting the procedure?
1. How the drainage was disposed 2. Quantity of drainage recorded on output record 3. Any client participation in the procedure 4. Assessment of stoma and skin around the stoma 5. The odor of the drainage