A client at a healthcare facility has been diagnosed with a nosocomial infection, caused
as a result of an exogenous microorganism. Which should the nurse consider to be
responsible for the client's condition?
A) Clostridium perfringens
B) Aspergillus
C) Escherichia coli
D) Neisseria species
B
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A patient has been vomiting for 2 days and has not been able to eat or drink anything during this time. She has not urinated for 12 hours. Physical examination reveals the following:
T = 99.6°F (37.6°C) orally; P = 110 beats/min, weak and thready; BP = 80/52 mm Hg. Her skin and mucous membranes are dry, and there is decreased skin turgor. The patient states that she feels very weak. The following are her laboratory results: Sodium 138 mEq/L Potassium 3.7 mEq/L Calcium 9.2 mg/dL Magnesium 1.8 mg/dL Chloride 99 mEq/L BUN 29 mg/dL Which of the following is an appropriate nursing diagnosis for this patient? a. Impaired Gas Exchange related to ineffective breathing b. Excess Fluid Volume related to limited fluid output c. Deficient Fluid Volume related to abnormal fluid loss d. Electrolyte Imbalance related to decreased oral intake
A patient has been casted to stabilize a fracture of the right radius and ulna. The nurse assesses a capillary refill of 5 seconds and cold fingers of the right hand. Which initial intervention should the nurse deploy?
a. Notify the charge nurse of a probable compartment syndrome b. Apply a warm compress to the fingers to relieve swelling c. Elevate the right hand to heart level to maintain arterial pressure d. Cut the cast off to release constriction
One of the goals of providing rehabilitation services to a patient with tetraplegia is to teach the patient to walk again.
Answer the following statement true (T) or false (F)
A patient tells the nurse that he has been informed he has internal hemorrhoids and asks whether there are different types of hemorrhoids. What is the nurse's most appropriate response?
a. "Internal hemorrhoids are usually seen outside the anus and appear blue." b. "Sometimes patients have other diseases, such as anal warts, that may be mistaken for internal hemorrhoids." c. "Internal hemorrhoids are found higher in the rectum and usually can't be felt unless they are infected or prolapsed." d. "Both internal and external hemorrhoids arise from the same general area and produce the same kinds of symptoms."