A new nurse is being oriented to work on the psychiatric unit. Which of the following statements reflect general principles for maintaining unit safety? Standard Text: Select all that apply
1. Staff should be sensitive to a client's need for privacy and personal space.
2. The staff should schedule their breaks during client mealtimes.
3. The nurse:client ratio should be at least one nurse for every four clients.
4. Staff should lock up clients' potentially dangerous items and permit use only under direct staff supervision.
5. Staff should provide frequent, short individualized contacts with clients.
1,5
Rationale: Staff should be sensitive to a client's need for privacy and personal space. Violation of these needs often leads to aggression.
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The nurse is transferring a patient who is in the progressive stage of shock into ICU from the medical unit. The medical nurse is aware that shock affects many organ systems and that nursing management of the patient will focus on what intervention?
A) Reviewing the cause of shock and prioritizing the patient's psychosocial needs B) Assessing and understanding shock and the significant changes in assessment data to guide the plan of care C) Giving the prescribed treatment, but shifting focus to providing family time as the patient is unlikely to survive D) Promoting the patient's coping skills in an effort to better deal with the physiologic changes accompanying shock
How often would a nurse recommend a patient eat or drink a source of vitamin C?
A) once a week B) once a month C) three times a week D) every day
An 83-year-old male has just been diagnosed with congestive heart failure. The nurse is making a home visit to teach him about the six medication that were just prescribed for him. To enhance learning, the nurse
A) allows the session to go as long as the client has questions. B) with the client's permission includes family members. C) provides most of the detailed information on teaching sheets. D) speaks in a loud, high-pitched voice.
While assessing a client's abdomen, the nurse observes involuntary reflex guarding on expiration. The nurse would interpret this as most likely indicating which of the following?
A) Hernia B) Malignancy C) Infection D) Aneurysm