Which of the following types of observation is the most narrow and highly focused?
A) Descriptive observation
B) Selective observation
C) Reflective observation
D) Focused observation
B
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. Restraints are utilized in certain circumstances to prevent the patient from harming himself or others. When a nurse uses a restraint on a patient, the nurse is infringing on which ethical principle?
A) Veracity B) Autonomy C) Double effect D) Fidelity
During a craniotomy, the patient experienced peripheral damage to cranial nerve VII, resulting in diminished movement of the left side of the face. What nursing action demonstrates best understanding of the effect of this lesion on the patient?
A) Referral for speech therapy and swallowing assessment B) Use of ocular moisturizers C) Teaching about falling and syncope risks D) Referral for evaluation for a hearing aid
The nurse is caring for a patient who is to receive intermittent bolus doses of phenytoin (Dilantin) through the IV line. Which intervention has the highest priority when administering this medication?
a. Check for blood return and compatibility prior to administration. b. Use a new IV tubing set each time the medication is administered. c. Document the date, time, and nurse's initials after each dose is administered. d. Use sterile gloves when drawing up and administering the medication.
Rh incompatibility can occur if the woman is Rh negative and her:
a. fetus is Rh positive. b. husband is Rh positive. c. fetus is Rh negative. d. husband and fetus are both Rh negative.