A 22-year-old client has suffered a spinal cord injury in which he is experiencing spinal shock and cannot feel his legs. Twenty-four hours after the injury, the client tells the nurse, "This will be good for me. I can handle this and I'm doing fine." Which response from the nurse is most likely indicated?

a. Ask the client if he would like to speak with a spiritual advisor or social worker
b. Document the client's positive attitude regarding this life-changing disability
c. Make arrangements for the client to be discharged to home
d. Continue to treat the client as is but remind him that he may never walk again


a. Ask the client if he would like to speak with a spiritual advisor or social worker

Nursing

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The ICU staff has been dealing with several distractions over the last week. There was a scheduling error caused by a change in the staffing matrix and miscommunication between management and administration

The staff is also caring for a client whose family has been verbally abusive and threatening. The manager notes an increase in absenteeism with the staff over the past 2 days. To which of these distractions is the absenteeism most likely related? 1. The staffing dilemma caused by the scheduler 2. The change in the staffing matrix 3. The decline in staff morale due to a hostile environment 4. The miscommunication between management and nursing administration

Nursing

What do standardized nursing care plans and individualized care plans have in common? They both:

1) Reflect critical thinking for a specific patient 2) Are preprinted to apply to needs common to a group of patients 3) Address a patient's individual needs 4) Provide detailed nursing interventions

Nursing

A maintenance man falls from a ladder into the unit hall, striking his head on some equipment. The man is unconscious and not breathing; the Code Team has already been paged and is on its way. The nurse should:

1. wait for the team to start CPR. 2. open airway with a jaw thrust. 3. give two rescue breaths after extending the neck. 4. start chest compressions.

Nursing

A patient is admitted with the diagnosis of possible acute pancreatitis. Upon assessment, the nurse notes faint bruising over the patient's flank region. How would the nurse report and document this finding?

1. Homan's sign 2. Cullen's sign 3. Grey Turner's sign 4. Chvostek's sign

Nursing