A nurse should assign which nursing diagnosis to a client needing assistance with assertiveness?
A. Disturbed personal identity
B. Disturbed thought processes
C. Defensive coping
D. Impaired verbal communication
ANS: C
Defensive coping reflects a self-protective pattern that defends against underlying perceived threats to positive self-regard. Clients who are utilizing defensive coping lack assertiveness skills.
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Many medications are available to control nausea and vomiting without oversedating the patient. At what point should a nurse normally administer antiemetics to a surgical patient?
A) Upon admission from PACU B) When the patient reports that he or she will soon vomit C) At the patient's first report of nausea D) When nonpharmacologic interventions are unsuccessful
Women who are prescribed a drug in Category X must be counseled to:
A. take the medication only on days during which no intercourse occurs. B. consistently use a reliable form of birth control. C. refuse the medication if using effective contraception. D. be tested for sexually transmitted diseases before beginning the drug.
A patient arrives in the emergency department with facial and chest burns caused by a house fire. Which action should the nurse take first?
a. Auscultate the patient's lung sounds. b. Determine the extent and depth of the burns. c. Infuse the ordered lactated Ringer's solution. d. Administer the ordered hydromorphone (Dilaudid).
A 32-year-old woman is scheduled for an induced abortion using instillation of hypertonic saline solution. Which information will the nurse plan to discuss with the patient before the procedure?
a. The patient will require a general anesthetic. b. The expulsion of the fetus may take 1 to 2 days. c. There is a possibility that the patient may deliver a live fetus. d. The procedure may be unsuccessful in terminating the pregnancy.