The nurse in the emergency department is caring for a pregnant Middle Eastern woman in the emergency department who presents with a broken wrist and multiple bruises. When asked how this happened, she states she fell down the stairs
The husband stays very close to his wife and does most of the talking. The nurse is aware that: 1. The patient likely did fall down the stairs.
2. The husband is being attentive and trying to help her feel better.
3. The husband could have battered her and possibly caused her to fall down the stairs.
4. This patient is safe to return home after her wrist is fixed.
3
Rationale 1: It is not likely that she just fell down the stairs on her own.
Rationale 2: It is possible that the husband is not to blame, but the nurse cannot determine that while he is present.
Rationale 3: The husband likely did do something to his wife and caused her to fall down the stairs.
Rationale 4: It would be questionable whether it would be safe for this patient to return home.
You might also like to view...
While palpating a client's uterus postpartum, the nurse notes the fundus position to be 2 centimeters higher than on previous assessments and off to the left side. Which of these actions should the nurse take?
a. Ask the client to urinate, and then reassess the fundus position. b. Initiate a Pitocin IV drip according to the health care provider's routine orders. c. Note the position of the uterus on the nurse's notes because these findings are normal. d. Notify the health care provider immediately.
Based on the nurse's knowledge of the progression of an epidural hematoma, which priority intervention is prepared for?
A) Insertion of an intracranial (IC) monitoring device B) Treatment with antihypertensives C) Emergency craniotomy D) Administration of anticoagulant therapy
A patient presents with severe bloody diarrhea and abscesses in the liver and brain. The patient is diagnosed with amebic dysentery, probably caused by
1. The ingestion of protozoa. 2. Fungi. 3. Helminths. 4. Bacteria.
The response to stress for older adults may be manifested differently than in younger adults. The nurse recognizes that. For the older adult client, the nurse is aware that:
1. Losses are more stress-provoking 2. Anxiety disorders are most prevalent 3. Psychosocial factors are the greatest threats 4. Timing of stress-inducing events is not significant