Which would be an expected outcome for a client with the following nursing diagnoses self-care deficit related to congnitive impairment:
a) The client will be able to name the staff that works on the day shift
b) The client will eliminate safety hazards in her environment
c) The nurse will stress the importance of adequate fluid intake
d) The client with supervision will brush her teeth
Answer: d) The client with supervision will brush her teeth
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A client with a long history of experiencing domestic violence tells the nurse, "There is no way out for me, this situation will never change." What nursing diagnosis would be most appropriate?
1. High Risk for Violence 2. Self-Esteem Disturbance 3. Alteration in Health Maintenance 4. Powerlessness
A mother reports that her child has episodes where he appears to be staring into space. This behavior is characteristic of which type of seizure?
a. Absence b. Atonic c. Tonic-clonic d. Simple partial
The nurse is administering packed red-blood cells to a child with sickle-cell disease (SCD). The nurse knows that a transfusion reaction will most likely occur
1. six hours after the transfusion isgiven. 2. within the first 20 minutes ofadministration of the transfusion. 3. at the end of the administrationof the transfusion. 4. never;children with SCD do not havereactions.
All treatments and services for patients require two forms of patient identification prior to providing those services. Which is the best method to use to identify the patient who is unable to communicate? (Select all that apply.)
a. Patient ID band b. Roommate c. Family member d. Admission photograph e. Asking another nurse who has cared for the patient previously