The nurse is collecting data for a patient with kidney disease. Which adventitious lung sound is the nurse most likely to note from fluid overload?
a. Wheezes
b. Crackles
c. Stridor
d. Pleural friction rub
ANS: B
Assessment of vital signs, lung sounds, edema, daily weights, and intake and output can provide valuable data related to urinary function. Fluid retention in the lungs is manifested as crackles, which are popping sounds heard on inspiration and sometimes on expiration.
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During transfer, equipment that must be readily available and accessible is/are
A) invasive monitoring equipment. B) cardiac medications and a defibrillator. C) a portable ventilator. D) an emergency surgery kit.
Which of the following statements best describes the relationship between nursing theory and nursing research?
A) Nursing theory and nursing research are mutually exclusive. B) Nursing theory utilizes a more holistic view of caring than does nursing research. C) Nursing research informs nursing theory and nursing theory informs nursing research. D) Nursing research is synonymous with nursing theory.
A patient diagnosed with schizophrenia had an exacerbation related to medication noncompliance and was hospitalized for 5 days. The patient's thoughts are now more organized, and discharge is planned. The patient's family says,
"It's too soon for discharge. We will just go through all this again." The nurse should: a. ask the case manager to arrange a transfer to a long-term care facility. b. notify hospital security to handle the disturbance and escort the family off the unit. c. explain that the patient will continue to improve if the medication is taken regularly. d. contact the health care provider to meet with the family and explain the discharge rationale.
Which of the following activities should the nurse implement to decrease shearing force on the client with a stage II pressure ulcer?
A) Support the client from sliding in bed B) Lubricate the area with skin oil C) Improve the client's hydration D) Pull client up under the arms