A patient tells the nurse that he is surprised that he has hepatitis because he didn't "turn yellow" like his friend who had the illness. Which of the following should the nurse respond to this patient?
1. that's a good point; maybe you don't have hepatitis
2. not everyone who has hepatitis develops jaundice
3. are you sure that your friend had hepatitis?
4. jaundice comes about 6 weeks after the disease starts
2
Rationale: Since only about 25% of people diagnosed with hepatitis develop jaundice, the correct response for the nurse to make would be that not everyone who has hepatitis develops jaundice. The nurse should not question the patient's diagnosis of jaundice. The nurse should also not question if the patient's friend really had hepatitis. If the patient is going to develop jaundice, it will manifest within 1 to 2 weeks from the onset of symptoms and not 6 weeks after the onset of symptoms.
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A patient in acute renal failure presents with a potassium level of 6.9 mg/dL. He has had no urine output in the past 4 hours despite urinary catheter insertion and Lasix 40 mg intravenous push
Vital signs are as follows: HR, 76 beats/min; respiratory rate, 18 breaths/min; and BP, 145/96 mm Hg. He is given 100 mL of 50% dextrose in water and 20 U of regular insulin intravenous push. A repeat potassium level 2 hours later shows a potassium level of 4.5 mg/dL. What order would now be expected? a. Sodium Kayexalate 15 g PO b. Nothing; this represents a normal potassium level c. Lasix 40 mg IVP d. 0.9% normal saline at 125 mL/hr
When assessing a client with cardiovascular problems, the nurse knows one of her assessments is the pulse
a. What are the pulse rhythm, volume, and deficit and how are they related? b. What would you see with peripheral pulses?
The mother of a 15-month-old child is questioning the nurse about the need for the hepatitis B vaccination. Which response by the nurse would be most appropriate?
A) "The most common side effect is injection site soreness." B) "This is a recombinant or genetically engineered vaccine." C) "Immunizations are needed to protect the general population." D) "This protects your child from infection that can cause liver disease."
Which duty would exceed the LPN/LVN scope of practice if included in the job description for an LPN/LVN charge nurse?
a. Assigning patient care b. Independently developing written treatment protocols c. Assisting physicians in diagnostic and therapeutic measures d. Maintaining a safe and hazard-free environment