The nurse is reviewing the plan of care for a client being treated with brachytherapy for breast cancer. Which assessment finding indicates that the client's skin integrity has been maintained?
A) Skin intact
B) Skin dry and excoriated
C) Skin stretched
D) Skin damp and sweaty
Answer: A
The goal for the client receiving radiation therapy to the chest is intact skin, which the nurse would expect to find. Skin that is damp with sweat, dry, or stretched is not consistent with radiation. If the goal were not met, the nurse would find excoriation.
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The nurse is collecting data for a patient who has a bulging eardrum. The nurse recognizes that this indicates which of the following?
a. Otitis media b. Hematoma in the middle ear c. External ear infection d. Normal tympanic membrane
A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the client can do to protect against errors?
a. Bring a list of all medications and what they are for. b. Keep the doctor's phone number by the telephone. c. Make sure all providers wash hands before entering the room. d. Write down the name of each caregiver who comes in the room.
Using the Five Wishes with patients at end of life is beneficial because:
a. it allows them to make their desires more specifically known b. it tells their wishes for their family after death c. it tells the five things that are most important to them d. none of the above
A nurse works in the intensive care unit. She enjoys being on the unit charge nurse team, the recruitment and retention team, and the peer evaluation team
The recruitment and retention team is responsible for hiring new employees into the intensive care unit. The five-member team, con-sisting of three registered nurses, a unit clerk, and a nurse's aide, conduct the interviewing process with key questions that were developed by the team. This is an example of ____. a. Centralized power b. Shared governance c. Span of control d. Vertical authority