The nurse has decided to add a nursing diagnosis to the client's drug therapy plan of care that represents wellness/health promotion. What is the most appropriate diagnosis to add to promote these areas?
a. Ineffective health maintenance related to not having recommended preventive care
b. Risk for injury related to side effect if drugs
c. Therapeutic regimen management, readiness for enhanced
d. Ineffective therapeutic regimen management related to lack of finances
ANS: C
This is the only diagnosis that would be classified as promoting wellness/health.
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The school nurse is conducting pediculosis capitis (head lice) checks. Which finding would indicate a "positive" head check?
1. White, flaky particles throughout the entire scalp region 2. Lesions on the scalp that extend to the hairline or neck 3. Maculopapular lesions behind the ears 4. Silver/white sacs attached to the hair shafts in the occipital area
Mr. J has read in the general press about the link between antioxidants and cardiovascular disease. Which of the following suggestions is the best advice to give him?
1. Drink a glass of red wine twice a day. 2. Take dietary supplements of the antioxidant vitamins in recommend dietary allowance amounts. 3. Include a citrus fruit or beverage with every meal. 4. Eat a generous amount of various fruits and vegetables.
The nurse is caring for a patient who has been diagnosed with stage I cancer of the colon. When assessing the need for psychologic support, which question by the nurse will provide the most information?
a. "How long ago were you diagnosed with this cancer?" b. "Do you have any concerns about body image changes?" c. "Can you tell me what has been helpful to you in the past when coping with stressful events?" d. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?"
A client develops postpartum hematoma as a result of prolonged pressure during labor
What are the initial nursing considerations for postpartum hematoma? A) Avoid giving an analgesic to the client B) Apply warm compresses at the perineal area C) Perform incision and ligation of a blood vessel D) Assess perineal area for discoloration and swelling