The nurse asks the patient to walk heel-to-toe, on the toes, and then on the heels. What function is the nurse assessing?
A. Brainstem
B. Midbrain
C. Cerebral
D. Cerebellar
Answer: D
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Which of the following nursing interventions is not consistent with the philosophy of psychiatric rehabilitation?
1. Performing a functional assessment of the client 2. Discharging a client from services when treatment goals are reached 3. Planning behavioral interventions that target specific functional deficits 4. Identifying highly individualized goals with the client
The nurse is caring for a client who received analgesic medication via central line to treat pain associated with cancer
After reassessing the client's response, which section of PIE will the nurse use when documenting the client's care? A) Evaluation B) Progress notes C) Problem D) Intervention
The nurse is caring for a patient who is declared brain dead and is an organ donor. The following events occur: 1300 Diagnostic tests for brain death are completed
1330 Intensivist reviews diagnostic test results and writes in the progress note that the patient is brain dead. 1400 Patient is taken to the operating room for organ retrieval. 1800 All organs have been retrieved for donation. The ventilator is discontinued. 1810 Cardiac monitor shows flatline. What is the official time of death recorded in the medical record? a. 1300 b. 1330 c. 1400 d. 1800 e. 1810
In a cardiac dysrhythmia clinic, a patient inquires about using acupuncture to help alleviate stress. The nurse's best answer is which of the following?
a. "It is acceptable, but do not use electro-acupuncture." b. "It is very clearly contraindicated." c. "Do not allow needles near the heart." d. "You do not look like you have an infection, so it will be OK."