The nurse assesses a stage I pressure ulcer on an older adult's coccyx by the appearance of a:
a. clear blister.
b. nonblanchable area of erythema.
c. scaly abraded area.
d. painful reddened area.
ANS: B
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A 59-year-old patient tells the nurse that he has ulcerative colitis. He has been having "black stools" for the last 24 hours. How would the nurse best document his reason for seeking care?
a. J.M. is a 59-year-old man seeking treatment for ulcerative colitis. b. J.M. came into the clinic complaining of having black stools for the past 24 hours. c. J.M. is a 59-year-old man who states that he has ulcerative colitis and wants it checked. d. J.M. is a 59-year-old man who states that he has been having "black stools" for the past 24 hours.
A patient has questioned the nurse's administration of IV normal saline, asking whether sterile water would be a more appropriate choice than "saltwater." Under what circumstances would the nurse administer electrolyte-free water intravenously?
A) Never, because it rapidly enters red blood cells, causing them to rupture. B) When the patient is severely dehydrated resulting in neurologic signs and symptoms C) When the patient is in excess of calcium and/or magnesium ions D) When a patient's fluid volume deficit is due to acute or chronic renal failure
In which state is the non-Hispanic White population less than 50% of the total population?
A. California B. Florida C. New York D. Illinois
How should the nurse determine the correct length of a nasogastric tube for placement into the stomach?
A) Place the distal tip to the nose, then the ear tip and the end of the xyphoid process. B) Instruct the patient to lie prone and measure tip of nose to umbilical area. C) Insert the tube into nose until the tube fills with secretions. D) Obtain an order from the physician for the number of inches to insert the tube.