The nurse understands that clients with cognitive disorders often experience spatial confusion as their diseases progress
Which of the following measures should be undertaken to maximize clients' safety and independence when navigating an inpatient facility?
A) Post large, simple maps on the walls of the facility in high-visibility locations.
B) Provide clients with a guided tour of the entire facility during admission.
C) Encourage clients to ask staff members for directions when they are spatially disoriented.
D) Post arrows, signs, and paths in the facility and increase lighting.
Ans: D
Obvious and visible aides such as bright arrows, signs, and paths are more likely to be of use to clients than maps, which require abstract reasoning. Bright lighting is important, and clients with cognitive disorders may not necessarily benefit from tours or reminders to ask for help.
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A visitor from Poland who does not speak English seems to be somewhat apprehensive about the nurse examining his neck. He would probably be more comfortable with the nurse examining his thyroid gland from:
a. Behind with the nurse's hands placed firmly around his neck. b. The side with the nurse's eyes averted toward the ceiling and thumbs on his neck. c. The front with the nurse's thumbs placed on either side of his trachea and his head tilted forward. d. The front with the nurse's thumbs placed on either side of his trachea and his head tilted backward.
Your patient is in hypovolemic shock. You know that antidiuretic hormone (ADH) plays a role during hypovolemic shock. What assessment finding will you likely observe related to the role of the antidiuretic hormone (ADH) during hypovolemic shock?
A) Increased hunger B) Decreased thirst C) Decreased urinary output D) Increased capillary perfusion
As long as dying clients remain competent, they have the right to request or refuse a variety of options and change their minds later
Indicate whether the statement is true or false
The nurse should report which assessment finding immediately to the health care provider?
a. The tympanum is blue-tinged. b. There is a cone of light visible. c. Cerumen is present in the auditory canal. d. The skin in the ear canal is dry and scaly.