Which finding in a pregnant patient would require further assessment by the nurse?
a. Heart rate of 90
b. Blood volume increase by 35%
c. Blood pressure of 150/92
d. White blood cell count of 16,000/mm3
ANS: C
An increased blood pressure in pregnancy requires further assessment. Increased heart rate, blood volume, and white blood cells are normal during physiologic changes during pregnancy.
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Prior to conducting a partial assessment with a 72-year-old client the nurse notes that the client intake and output are balanced even though a previous note indicates that the client is dehydrated based upon dry skin
What should the nurse conclude about this information? 1. The client is dehydrated. 2. The accuracy of the earlier assessment is in question. 3. The client's condition has deteriorated. 4. The client has increased fluid intake.
The nurse is reviewing the actions that a patient with type 1 diabetes mellitus should take if mild hypoglycemia is experienced. What should the nurse include in this teaching?
Select all that apply. 1. Test blood glucose 30 minutes after reaching 70 mg/dL. 2. Ingest 4 ounces of fruit juice when blood glucose is below 70 mg/dL. 3. Measure blood glucose 15 minutes after ingesting a carbohydrate source. 4. Add table sugar to 8 ounces of fruit juice when blood glucose is below 70 mg/dL. 5. Ingest additional 15 grams of carbohydrate if blood glucose remains low after 15 minutes.
A preterm fetus with persistent supraventricular tachycardia that is not hydropic is best treated with maternal administration of
A. Digoxin B. Phenobarbital C. Terbutaline
A patient is very restless and agitated near the end of life, and the physician orders haloperidol (Haldol) PO. The patient coughs and chokes every time foods or fluids are offered. Which nursing action is most appropriate?
a. Crush the medication, and mix it with applesauce. b. Dissolve the medication in a small amount of water, and administer it with an oral syringe. c. Ask the physician for an order to administer the Haldol intramuscularly. d. Hold the medication until the patient is more alert and able to swallow.