A 75-year-old patient is breathing at a rate of 30 and denies dyspnea. The breath sounds are clear to auscultation in all five lobes
The nurse will further assess the patient's respiratory and circulatory systems by checking capillary refill. A normal finding would be
1. Nail beds pink, capillary refill 6 seconds.
2. Nail beds cyanotic, capillary refill 4 seconds.
3. Nail beds pink, capillary refill 5 seconds.
4. Nail beds blanched, capillary refill 3 seconds.
ANS: 3
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The nurse plans care for the client who receives a prescription for a leg brace and crutches. Which is the nurse's priority in the client's plan of care?
1. Assist client to supine position to apply the leg brace. 2. Ask which device the client prefers and uses most often. 3. Determine client experience with leg brace and crutches. 4. Assess how the leg brace affects ambulation with crutches.
Parents are concerned about their child becoming obese so want to limit the fat intake of their 2-year-old by switching to skim milk and fat-free foods. What advice should the nurse give to these parents?
1. "Preventing obesity is a good goal; limiting fat is the first step.". 2. "This is a reasonable goal only if you think obesity is a problem in your family.". 3. "Toddlers need fats to grow so this is not a time to severely limit fat.". 4. "As long as your toddler gets about 25% of calories from fats, this is reasonable.".
A major goal of the community health nurse's community assessment is to determine:
a. how affluent the community is and how the family compares to the average in terms of income b. the influences of the larger environment on the child's and family's health and development c. how many churches and of what type are in the community and how the spiritual needs of the family are met d. how to get health care practitioners to accept nurse practitioners and to take Medicare assignment
Which patient is most at risk for postoperative nausea and vomiting (PONV)?
a. The patient with a history of motion sickness b. The patient with a nasogastric tube c. The patient who recently experienced weight loss of 50 pounds d. The patient who had minimally invasive surgery (MIS)