A client calls for pain medication for excruciating pain. When approaching the client's room with the medication, the nurse overhears the client laughing and talking on the phone
Upon entering the room, the nurse notes the client is sitting in the bedside chair in no apparent distress. In this situation the nurse would consider the client's verbal and nonverbal communications to be: a. appropriate c. incongruent
b. confusing d. therapeutic
C
It is important for nurses to observe verbal and nonverbal messages, both their own and those of clients, and to follow through to clarify these messages. The nurse needs to determine if the client's verbal and nonverbal communications would be considered congruent, or sending the same message.
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An elderly patient explains to the nurse that while weeding his garden, he was suddenly startled by a 6-foot non-poisonous snake. He immediately displayed extreme fear and suddenly had a burst of energy and ran from the snake
The nurse realizes that this client is describing which of the following stages identified in GAS? A. Exhaustion B. Problem solving C. Crisis D. Delirium
At the completion of the physical assessment, you should discuss future plans and answer any questions the patient may have after
a. assisting the patient to a sitting position. b. documenting your findings. c. formulating a nursing care plan. d. providing adequate time for the patient to redress.
Which diagnosis is a wellness diagnosis?
A) Body image disturbance B) Risk for aspiration C) Ineffective breastfeeding D) Health-seeking behaviors
The nurse is caring for a baby born to a patient who is addicted to heroin. What manifestations will the nurse most likely assess in this newborn? (Select all that apply.)
A) Tremors B) Lethargy C) Sneezing D) Vomiting E) Shrill high-pitched cry