A patient enters the emergency department in an addisonian crisis. Vital signs are blood pressure 85/52 mm Hg and pulse 88 beats/min. The patient is lethargic. Which event in the patient's week most likely precipitated this crisis?
a. Taking Tylenol for a headache
b. Maintaining usual exercise of walking each night
c. Eating a high-fat diet
d. Being laid off from a job
ANS: D
Stress causes a need for an increase in cortisol, the body's stress hormone. Being laid off is a stressor. Tylenol, walking, and a high-fat diet are not unusually stressful.
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The care team has deemed the occasional use of restraints necessary in the care of a patient with Alzheimer's disease. What ethical violation is most often posed when using restraints in a long-term care setting?
A) It limits the patient's personal safety. B) It exacerbates the patient's disease process. C) It threatens the patient's autonomy. D) It is not normally legal.
During the third week of treatment, the spouse of a patient in an alcoholism rehabilitation program says, "After this treatment program, I think everything will be all right.". Which remark by the nurse will be most helpful to the spouse?
a. "It is good that you're supportive of your spouse's sobriety and want to help maintain it.". b. "While sobriety solves some problems, new ones may emerge as one adjusts to living without alcohol.". c. "It will be important for you to structure life to avoid as much stress as you can. You will need to provide social protection.". d. "Alcohol is a lifelong disease of self-destruction. You will need to observe your spouse's behavior carefully.".
A diabetic patient has been admitted with renal failure. The nurse will monitor for the most life-threatening effect of renal failure which is the:
A) Accumulation of wastes B) Retention of potassium C) Depletion of calcium D) Lack of blood pressure control
The priority nursing diagnosis of a 45-year-old client with auditory hallucinations would be:
A) Risk for violence, self-directed or directed toward others. B) Impaired thought processes. C) Impaired verbal communication. D) Individual ineffective coping.