The technical or vocational nurse agrees that an appropriate nursing diagnosis for a person with Parkinson's disease would be:
a. Risk for falls related to unsteady gait.
b. Ineffective airway clearance related to drooling.
c. Risk for impaired skin integrity related to tremor.
d. Nutrition: less than body requirements related to nausea.
A
Rigidity and impaired balance with the propulsive gait create a risk for falls. The tremor de-creases with voluntary movement, making eating relatively trouble free. Drooling is not a threat for aspiration, and there is no characteristic nausea.
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A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the client's oxygen saturation has not significantly improved. What response by the nurse is best?
a. "Breathing so rapidly interferes with oxygenation." b. "Maybe the client has respiratory distress syndrome." c. "The blood clot interferes with perfusion in the lungs." d. "The client needs immediate intubation and mechanical ventilation."
The nurse is planning to instruct a patient who is 6 weeks pregnant about increasing the intake of milk each day. Which statement should the nurse make as the most effective health teaching measure?
A) "The fetus needs milk to build strong bones and teeth.". B) "Your future baby will benefit from a high milk intake.". C) "Milk is a rich source of calcium that is important for fetal growth.". D) "Milk will strengthen your fingernails as well as be good for the baby.".
The nurse explains to a client with chronic renal failure that the rationale for receiving calcium carbonate is that it
a. binds with phosphorus to eliminate it from the body. b. binds with potassium to eliminate it from the body. c. helps prevent constipation. d. helps prevent ulcer formation.
The three major types of pain have similarities. However, acute pain differs from chronic and cancer pain in that it usually:
A. Varies in intensity B. Lasts less than 6 months C. Has a rapid onset D. Is assessed based on subjective responses