A 37-year-old client has never married and has remained at home with his aging mother. A community health nurse visits the family once a month to administer vitamin B12 injections to the mother
On one of these visits, the client confides to the nurse that he is terrified of what will happen to him when his mother dies. Although the client's mother is the community health nurse's primary client, the nurse identifies the client's need for intervention regarding his low self-esteem. Which nursing diagnosis does the nurse identify for this client?
A) Self-esteem disturbance
B) Chronic low self-esteem
C) Situational low self-esteem
D) Social isolation
B
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The intensive care nurse is performing a cardiac assessment on a newly admitted older adult client and notes the following findings:
peripheral edema, jugular venous distention of 5 cm above the sternal angle when the client is at a 45-degree angle, and an enlarged liver. Based on this data, which diagnosis does the nurse suspect? 1. Pulmonary edema. 2. Left-sided heart failure. 3. Myocardial infarction. 4. Right-sided heart failure.
The nurse is assessing a client with peritonitis. Which of the following symptoms would the nurse observe in this client?
A) Bowel sounds are mild. C) Bowel sounds are hyperactive. B) Bowel sounds are high-pitched. D) Bowel sounds are not present.
The nursing student uses evidence-based practice findings in the development of a care plan. This is an example of which type of nursing skill?
A) Cognitive skill B) Technical skill C) Interpersonal skill D) Ethical/legal skill
After laboratory tests are completed, it has been determined that a client is adhering to medication and diet therapy to control type 1 diabetes mellitus. Which of the following diagnostic tests would provide this information?
1. Fasting blood glucose level 2. Two-hour postprandial glucose level 3. Hemoglobin A1c 4. Blood glucose level at hour of sleep