Clustering of data to ascertain a nursing diagnosis is accomplished through the use of
A) General systems theory process
B) Problem-solving process
C) Decision-making process
D) Information-processing theory
Ans: D
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Which does the nurse include in client teaching about acid-base balance?
1. Carbonic acid forms from the byproducts of metabolic activity. 2. The respiratory system efficiently regulates acid-base balance. 3. Metabolic acidosis results from excess blood flow to the kidneys. 4. Taking odium bicarbonate decreases hydrogen ions in the blood.
A home health nurse is visiting a Latino American client who has become ill. Which characteristic of the Latino American culture should the nurse consider when planning care for this client?
A) Latino Americans shy away from any form of touch. B) Latino Americans tend to be future-oriented. C) Roman Catholicism is the predominant religion, although the influence of the church is weak. D) When illness is encountered, the first contact is often with the curandero (folk healer).
A 7-year-old child is diagnosed with chickenpox. Which eruption is the first to be seen
in chickenpox? A) Papules B) Vesicles C) Pustules D) Crusts
The nurse is performing a musculoskeletal assessment on a client admitted with a possible stroke. When testing for muscle grip strength, the nurse should ask the client to:
1. Grasp the nurse's index and middle fingers while the nurse tries to pull the fingers out. 2. Hold an arm up and resist while the nurse tries to push it down. 3. Flex each arm and then try to extend it against the nurse's attempt to keep the arm in flexion. 4. Shrug the shoulders against the resistance of the nurse's hands.