The nurse notes a client that has received intravenous vancomycin (Vancocin) develops an upper body rash and has a decreased urine output. In addition to notifying the healthcare provider, which is the nurse's priority action?
A. Hold the next dose of vancomycin (Vancocin).
B. Obtain a stat x-ray.
C. Administer an antihistamine.
D. Obtain a sterile urine specimen.
Answer: A
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A nurse reviews vital signs for a patient admitted last night with an injury sustained while intoxicated
The medical record shows these blood pressure and pulse readings: Admission, 2 AM - 118/78 mm Hg and 72 beats/min 4 AM - 126/80 mm Hg and 76 beats/min 6 AM - 128/82 mm Hg and 72 beats/min 8 AM - 132/88 mm Hg and 80 beats/min 10 AM - 148/94 mm Hg and 96 beats/min What is the nurse's priority action? a. Force fluids. b. Consult the health care provider. c. Obtain a clean-catch urine sample. d. Place the patient in a vest-type restraint.
The clinic nurse is aware of family diversity and the number of woman-led families in the United States. Currently the number of families where a woman is the head of household is approximately:
A) 40% B) 50% C) 60% D) 70%
In working with a client with paranoid personality disorder, the MOST therapeutic approach would be for the nurse to:
a. use a strict tone of voice to enforce limit setting b. avoid giving the client any choices in matters c. employ a teaching manner to provide information d. maintain a nonemotional and matter-of-fact manner
The community health nurse is assessing the health risk of the family. Using your knowledge that families approach the idea of health risk in many different ways, what are factors to consider?
1. What they learn from their present experience in their family of origin 2. Economic circumstances, especially health care insurance coverage 3. Stress and coping styles 4. Internal and external culture A) 1, 2, 3 B) 1, 3, 4 C) 2, 3, 4 D) 1, 2, 3, 4