A client is admitted with a possible deep vein thrombosis. Nursing interventions should be implemented to prevent which complication?
1. Myocardial infarction
2. Renal failure
3. Pulmonary embolism
4. Pneumonia
3. Pulmonary embolism
Rationale:
The presence of a deep vein thrombosis is a risk factor for the development of a pulmonary embolism. The nurse should design interventions to help prevent that development. There is less likelihood that the thrombosis would cause myocardial infarction, renal failure, or pneumonia.
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The nurse is caring for a client in the intensive care unit. This client is at risk for sensory overload, which can manifest in the following manner: Standard Text: Select all that apply
1. Decreased attention span 2. Irritability 3. Scattered attention 4. Hallucinations 5. Emotional lability
The nurse explains to the patient whose membranes ruptured an hour ago that delivery is usually accomplished in ____ to _____ hours postrupture
Fill in the blank(s) with correct word
The client had the right trigeminal nerve (all branches) dissected 1 day ago during microvas-cular surgery. When the client is asked to wrinkle his forehead, only the left side wrinkles. What is the nurse's best action?
A. Place the client in a high Fowler's position. B. Document the finding as the only action. C. Assess the corneal reflex. D. Notify the physician.
Environment as defined within the community nurse practice model refers to
A. External conditions or surroundings B. The whole environment C. Encirclement D. Conditions that surround the nurse