The emergency department nurse is assessing a patient with abdominal trauma after a motor vehicle accident. The patient has become somewhat confused, his skin is pale, cool, and moist and he has had only 20 mL of urine output during the past hour. What does the nurse suspect?
a. Hypovolemic shock
b. Head injury
c. Liver laceration
d. Large bowel injury
Answer: a. Hypovolemic shock
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A patient's blood gas levels are pH of 7.2, PaCO2 of 55 mm Hg, and HCO3 of 24/L. The patient has a
A) metabolic acidosis. B) metabolic alkalosis. C) respiratory acidosis. D) respiratory alkalosis.
The nurse interprets the physician's finding of a grade of 2/5 on the Achilles tendon to mean what has occurred?
a. Hyperreflexive response for the fifth and sixth cervical nerves b. Exaggerated response for the seventh and eighth cervical nerves c. Normal response for the first and second sacral nerves d. Weak response for the second through the fourth lumbar nerves
The purpose of Leopold's maneuvers is to determine:
a. The expected date of delivery b. The presentation and position of the fetus c. The fetal heart rate d. Exact pelvic measurements
A patient has just received a prescription for an enteric-coated stool softener. when teaching the patient, the nurse should include which statement
A. "take the tablet with 2 or 3 ox of orange juice." B. "avoid taking all other medication with any enteric-coated tablet." C. "Crush the tablet before swallowing if you have problems with swallowing." D. "be sure to swallow the tablet whole without chewing it."