The nurse is caring for a patient in traction. Which actions are appropriate when caring for this patient? (Select all that apply.)
a. Allow weights to hang freely in place.
b. Use assistance to reposition the patient in bed.
c. Hold weights up if the patient is shifting position in bed.
d. Remove weights if the patient is being moved up in bed.
e. Lighten weights for short periods if the patient reports pain.
ANS: A, B
Weights are to hang unobstructed. Assistance should be used to pull the patient up in bed to protect the health care worker from injury. C. D. E. Weights should never touch the floor or be removed or lifted.
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Thrombophlebitis may be prevented by completing which one of the following nursing interventions?
A. Gentle massaging of extremities. B. Maintaining bed rest until taking in adequate p.o. fluids. C. Providing deep breathing exercises. D. Dangling client at side of bed for an extended time.
After relocating to new community, a 60-year-old man has presented for care to a nurse practitioner. During the nurse's initial health assessment, the man states that he has had a diagnosis of gastroesophageal reflux disease (GERD) for several years
The nurse should anticipate that a medication reconciliation is likely to reveal that the man has been prescribed: A) A calcium channel blocker B) A proton pump inhibitor (PPI) C) A bisphosphonate D) A nitrate
The nurse would be least likely to find which of the following in a client with uterine fibroids?
A) Regularly shaped, shrunken uterus B) Acute pelvic pain C) Menorrhagia D) Complaints of bloating
The preoperative patient has called the nurse about his upcoming surgical procedure, which will be six weeks from now. He is concerned about receiving blood after surgery for fear of acquiring a bloodborne disease
Which of the following might the nurse do? A) Instruct the patient to notify the physician. B) Remind the patient that blood is tested prior to administration, making it safe and free of disease. C) Ask the patient if he has ever had any blood products. D) Explain to the patient the use of autologous blood donation. E) Instruct patient to refuse transfusion.