The nurse assessing an elderly client for suicide potential should include questions about mood as
well as seek information about (more than one option may be correct)
A. sleep pattern changes.
B. increased appetite.
C. increased concern with bodily functions.
D. enhanced self-esteem.
E. anhedonia and anergia.
A, C, E
Rationale: These symptoms are often noted in elderly clients with depression. Somatic symptoms are
often present but are missed by nurses as being related to depression. Option B: Anorexia, rather
than hyperphagia, is seen in major depression. Option D: Low self-esteem is more often associated
with major depression.
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A patient has underlying cardiac disease and requires careful monitoring of his fluid balance. He also has a draining wound. Which of the following methods for evaluating his wound drainage would be most appropriate for assessing fluid loss?
a. Draw a circle around the area of drainage on a dressing. b. Classify drainage as less or more than the previous drainage. c. Weigh the patient at the same time each day on the same scale. d. Weigh dressings before they are applied and after they are removed.
A nurse is planning a research study to answer a clinical question. Which of the following would be most appropriate for a qualitative research approach?
A) Evaluating the reported cases of complications after varicella immunization B) Determining the use of complementary and alternative health care by middle-aged adults in rural areas C) Ascertaining the effect of using calming music on older adults with dementia in extended care facilities D) Assessing the emotional responses and feelings of individuals requiring isolation due to a highly communicable illness
While providing medication, the client states that one pill does not look the same as the medication she takes at home. What should the nurse do?
1. Tell the client that the physician ordered the drug. 2. Check with the nursing supervisor. 3. Clarify the order with the physician. 4. Give the medication to the client.
A client has been prescribed the xanthine oxidase inhibitor allopurinol for treatment of gout. Which statement by the client indicates that nursing education about this drug has been successful?
1. "I should take my blood pressure weekly while on this medication." 2. "I will monitor my skin for rashes." 3. "This drug may cause gastrointestinal bleeding, so I should watch for tarry stools." 4. "While I am taking this medication, my ability to heal will be reduced."