A newly admitted patient is in acute pain, has not been sleeping well lately, and is having difficulty breathing. How should the nurse prioritize these problems?
a. Breathing, pain, and sleep
b. Breathing, sleep, and pain
c. Sleep, breathing, and pain
d. Sleep, pain, and breathing
ANS: A
First-level priority problems are immediate priorities, remembering the ABCs (airway, breathing, and circulation), followed by second-level problems, and then third-level problems.
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a. Sensory deficits b. Sensory overload c. Sensory deprivation d. Changes in attitudes
Prior to applying the condom catheter, which action by the nurse is the most appropriate?
1. Documenting the use of the catheter 2. Inspecting and cleansing the penis 3. Calling the health care provider to obtain an order 4. Attaching the urinary drainage system securely
Why should a nurse monitor food and fluid intake and toilet patterns of clients with mental disabilities?
A) Regular checkup B) Data collection facilitates problem identification C) To determine common symptoms D) Physician's record
The school nurse is working with a 13-year-old boy who recently was diagnosed with insulin-dependent diabetes. Which of the following would be one of the areas on which the teaching discussion should focus?
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