A nurse answers a suicide crisis line. A caller says, "I live alone in a home several miles from my nearest neighbors. I have been considering suicide for 2 months. I have had several drinks and now my gun is loaded
I'm going to shoot myself in the heart." How would the nurse assess the lethality of this plan?
a. No risk
b. Low level
c. Moderate level
d. High level
ANS: D
The patient has a highly detailed plan, a highly lethal method, the means to carry it out, lowered impulse control because of alcohol ingestion, and a low potential for rescue.
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A client takes celecoxib (Celebrex) for chronic osteoarthritis in multiple joints. After a knee replacement, the health care provider has prescribed morphine sulfate for postoperative pain relief
The client also requests the celecoxib in addition to the morphine. What action by the nurse is best? a. Consult with the health care provider about administering both drugs to the client. b. Inform the client that the celecoxib will be started when he or she goes home. c. Teach the client that, since morphine is stronger, celecoxib is not needed. d. Tell the client he or she should not take both drugs at the same time.
A 3-year-old boy with encephalitis is scheduled for a lumbar puncture. Which of the following actions by the nurse would demonstrate atraumatic care?
A) Using EMLA prior to lumbar puncture B) Having his anxious mother stay in the waiting room C) Explaining, using medical terms, what will happen D) Starting the child's intravenous infusion in his room
The nurse is assessing a patient diagnosed with gastrointestinal bleeding. Which finding should alert the nurse that the patient's condition is deteriorating?
1. The patient reports feeling very tired. 2. Urinary output has increased over the previous hour to 50 mL. 3. The patient's skin is warm and dry. 4. Capillary refill time has increased.
A client periodically experiences pseudofolliculitis barbae. Which of the following should the nurse instruct this client?
1. Avoid close shaving. 2. Avoid washing the hair prior to shaving. 3. Apply a topical antibiotic. 4. Contact the physician since the client needs a prescription for an oral antibiotic.