The client's urinary output is normal, whereas respiratory rate and heart rate are slightly elevated from baseline. Which of the following should the nurse suspect?
A. Early stage of shock
B. Compensatory stage of shock
C. Intermediate stage of shock
D. Refractory stage of shock
A
An increase in heart and respiratory rates (heart rate first) from the client's baseline or a slight increase in diastolic blood pressure may be the only objective manifestations of early shock.
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The mother of a school-aged child brings the child to the clinic for evaluation because he is having difficulty reading. His last visual screening was normal. He also complains of headaches and dizziness
Which of the following would the nurse suspect? A) Astigmatism B) Myopia C) Hyperopia D) Nystagmus
A patient who just suffered a hemorrhagic stroke is brought to the emergency department by ambulance. What should be the nurse's primary assessment focus?
A) Cardiac and respiratory status B) Seizure activity C) Urinary output D) Fluid and electrolyte balance
The patient with a right-sided paralysis from a stroke becomes frustrated when attempting to self-feed. He throws the spoon at the nurse and begins to cry. What nursing action(s) is/are most appropriate at this time? (Select all that apply.)
a. Retrieve the spoon and sit quietly for a few seconds. b. Touch the patient and inquire if he would rather have a high-protein milkshake for his meal. c. Remind the patient that such behavior is not acceptable. d. Add an intervention to the NCP for in-creased support with self-feeding. e. Complete an incident report.
You anticipate that your region will soon move towards an e-health record system. You begin to discuss this with your staff and are disappointed that you receive little positive response from the staff about this possibility. One staff member, in particular, seems to sum it up by saying "e-health? Won't happen in my working life! There are too many problems with it, like privacy issues." This response is most likely motivated by:
a. Lack of urgency regarding the need to change.
b. Lack of evidence to support importance of technology.
c. Deficits in education and experience.
d. Lack of organizational support for change.