The nurse is assessing a new patient in the clinic. The nurse knows that the subjective (presumptive) signs and symptoms of pregnancy include:
1. Positive urine pregnancy test, enlarged abdomen, and Braxton Hicks contractions.
2. Positive urine pregnancy test, amenorrhea, fatigue, and softening of the cervix.
3. Increase in urination, amenorrhea, fatigue, breast enlargement, and quickening.
4. Enlarged abdomen and fetal heartbeat.
3
Rationale 1: A positive urine pregnancy test, enlarged abdomen, and Braxton Hicks contractions are objective (probable) changes of pregnancy
Rationale 2: A positive pregnancy test, fatigue, and softening of the cervix are objective (probable) changes of pregnancy.
Rationale 3: An increase in urination, amenorrhea, fatigue, breast enlargement, and quickening are all subjective (presumptive) changes of pregnancy.
Rationale 4: An enlarged abdomen is an objective (probable) change of pregnancy, and a fetal heart beat is a diagnostic (positive) change.
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a. disorientation. b. feelings of helplessness. c. emergence of bodily symptoms. d. anger and hostility.
The family of a critically ill patient reports to the nurse concerns that none of the healthcare team members seem to be listening to their wishes. Which nursing response is indicated?
1. "You have to stand up for yourself and for your loved one." 2. "It is time for us to meet in a patient care conference." 3. "I will talk to the hospital administrator about your complaint." 4. "I know this whole thing has been very hard on your family."
The nurse is providing care to a patient who is in labor. Which type of pain is this patient experiencing?
1) Acute 2) Chronic 3) Malignant 4) Chronic pain syndrome
While being comforted in the emergency department, a young school-age sibling of a pediatric trauma victim blurts out to the nurse, "It's all my fault! When we were fighting yesterday, I told him I wished he was dead!"
Which response is most appropriate by the nurse? 1. Asking the child if she would like to sit down and drink some water 2. Sitting the child down in an empty room with markers and paper so that she can draw a picture 3. Calmly discussing the catheters, tubes, and equipment that the patient requires and explaining to the sibling why the patient needs them 4. Reassuring the child that it is normal to get angry and say things that we do not mean but that we have no control over whether or not an accident happens