The nurse is teaching parents of a school-age child how to cleanse small wounds. What should the nurse advise the parents to avoid using to cleanse a wound? (Select all that apply.)
a. Alcohol
b. Normal saline
c. Tepid water
d. Povidone–iodine
e. Hydrogen peroxide
ANS: A, D, E
Caution caregivers to avoid cleansing the wound with povidone–iodine, alcohol, and hydrogen peroxide because these products disrupt wound healing. Normal saline and tepid water are safe to use when cleansing wounds.
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Since losing his right leg years ago, Mr. Smith and his wife have formed a community walking group to raise money for the homeless in his area. Which of the following has contributed to him being viewed as "healthy"?
A) The client is married and is moving on. B) The client is experiencing high quality of life within the limits of the physical condition. C) The client is facing various states of health and illness. D) The client is physiologically and psychologically stable.
A client asks the nurse what ventilation is. What is the most appropriate response by the nurse?
1. "Ventilation is the process by which gases are exchanged." 2. "Ventilation is the process of moving air into and out of the lungs." 3. "Ventilation is the blood flow through the lung." 4. "Ventilation is taking a breath in."
The nurse is talking with a patient who was just prescribed zonisamide (Zonegran). Which patient statement should the nurse immediately discuss with the patient's health care provider?
1. "Did I mention that I used to take phenobarbital for my seizures?" 2. "I forgot to tell the doctor that I am allergic to sulfa drugs." 3. "I have lactose intolerance, so I can't drink milk." 4. "My husband and I plan to have a baby in a couple of years." 5. "My husband and I are leading a 20-mile bicycle tour next weekend for the company we have just started."
The nurse is assessing a client who is diagnosed with borderline personality disorder. Which of the following statements made by the client indicates the client is at risk for self-injurious behavior?
A) "I have felt so down lately. I don't enjoy doing anything anymore." B) "I am so worried about what is going to happen to me." C) "When I feel extremely anxious, it is like my mind goes somewhere else." D) "It is almost as if as soon as I think of doing something, I immediately do it."