The nurse is assessing a wound using the technique shown in this picture. How would the nurse document this assessment?
1. The wound is macerated.
2. The wound is tunneled.
3. The wound is deep.
4. The wound is filled with exudate.
Answer: 2
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The American Nurses Association's Nursing Scope and Standards of Practice:
a. addresses the profession's concern with the quality and accountability of nursing. b. describes both professional and vocational nursing standards of care. c. describes the profession's non-negotiable ethical standards. d. focuses on standards of care strictly applicable to clinical practice.
A nurse is giving an educational class to members of the local disaster team. What should the nurse instruct members of the disaster team to do in a chemical bioterrorist attack?
A) Cover their eyes. B) Put on a personal protective equipment mask. C) Stand up. D) Crawl to an exit.
The nurse is helping a patient set a goal for ambulating after surgery. Which outcome statement for this patient with generalized postoperative weakness is best?
a. The patient transfers self safely from the bed to the chair 3 times daily. b. The nurse will maintain his or her physical mobility after surgery. c. The patient will remain safe from falls and postoperative anxiety. d. The patient transfers self safely from bed to chair 4 times daily within 2 days.
A middle-aged obese male patient with elevated triglycerides and a history of smoking two packs of cigarettes a day for 20 years asks about the risk for coronary artery disease. What information should the nurse provide?
A. He is at risk for coronary artery disease. B. He has nothing but nonmodifiable risk factors for coronary artery disease. C. He has nothing but modifiable risk factors for coronary artery disease. D. He is not at risk for coronary artery disease.