A client has a large oral tumor. What assessment by the nurse takes priority?
a. Airway
b. Breathing
c. Circulation
d. Nutrition
ANS: A
Airway always takes priority. Airway must be assessed first and any problems resolved if present.
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A student nurse asks the nursing instructor what "apoptosis" means. What response by the instructor is best?
a. Growth by cells enlarging b. Having the normal number of chromosomes c. Inhibition of cell growth d. Programmed cell death
The client is receiving sodium chloride 0.45% by IV infusion. If the fluid is infused beyond the client's tolerance, the client is at risk for:
1. cardiac overload. 3. cellular dehydration. 2. water intoxication. 4. increased osmotic pressure.
The client experienced a sports-related injury to his leg. During the morning assessment, what signs of inflammation will the nurse most likely assess? (Select all that apply.)
1. Pallor 2. Swelling 3. Pitting edema 4. Warmth 5. Pain
A client who had been attending the day program and receiving a long-acting depot antipsychotic injection has not come to the program for 3 weeks. People in the group have seen this client shopping at the mall
Which intervention by the nurse case manager would be MOST appropriate? a. Make a home visit, and offer to give the overdue Haldol in the home. b. Call a team meeting, and discuss discharging this client from the program. c. Ask the group members to tell the client when they see him that he is missed and is welcome to come back. d. Call the client on the telephone, and ask if he would like to continue or if he decided not to come again.