The community mental health nurse is told about a person who lives under a covered bridge in the community. When the nurse finds this client, he tells her that he owns the bridge because he is king of the county
He obtains his food from handouts from families who live in the area and by fishing in the stream. Which nursing diagnosis is appropriate? a. Social Isolation
b. Impaired Sensory Perceptions: Delusions
c. Ineffective Individual Coping: Alcoholism
d. Hopelessness
B
The primary diagnosis would be Impaired Sensory Perceptions: Delusions. The client's statement that he owns the bridge because he is king of the country is an example of a delusion of grandeur.
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The nurse can reduce the risk of access site infection in a client receiving TPN by
a. adding antibiotics to the TPN fluid. b. changing the catheter every 48 hours. c. changing the transparent dressing every 72 hours. d. using a semipermeable dressing on the insertion site.
The nurse is preparing a presentation on serious mental illness. Which health problem should be included? (Select all that apply.)
1. Major depressive disorder 2. Schizophrenia 3. Adjustment reaction 4. Bipolar disorder 5. Social phobia
For several months a patient has been experiencing an infection of the cuticle involving several fingernails on both hands. Which type of employment should the nurse suspect is causing this patient's health problem?
A. Construction worker B. Dish washer C. Painter D. Carpenter
The major extracellular anions are:
A. phosphate and carbonate. B. bicarbonate and chloride. C. bicarbonate and phosphate. D. lactate and chloride.