An instructor is reviewing the steps to obtain a radial pulse. The instructor determines that the teaching was successful when the students demonstrate which of the following?
A) Application of firm pressure on the wrist area along the side of the fifth digit
B) Use of two middle fingers lightly applied to wrist area along the thumb side
C) Use of the thumb and index finger applied to obliterate the wrist area along the thumb side
D) Application of the bell of the stethoscope to the antecubital area of the upper extremity
B
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The nurse is preparing to assess a laboring primiparous client who has just arrived in the Labor and Birth unit. Which statement indicates that additional education is needed?
1. "You are going to do a vaginal exam to see how far dilated my cervix is." 2. "The reason for a pelvic exam is to determine how low in the pelvis my baby is." 3. "When you check my cervix, you will find out how thinned out it is." 4. "After you assess my pelvis, you will be able to tell when I will deliver."
A client who is a victim of domestic violence is visited by her husband in the hospital. To support the client, the nurse should:
1. Refuse to permit the husband to visit with the client. 2. Ask the client if there is anything that she needs at this time. 3. Call security to have the husband removed. 4. Call the police to have the husband arrested for assault.
The nurse is placing a restraint on an elderly male client who is on bed rest and attempts to get out of bed to go to the bathroom. Which of the following is a guideline when using restraints?
A) For a client on bed rest, physical restraints are the recommended option. B) Generally, a physician's order is required to apply restraints. C) Restraints should be used when nursing staff is inadequate to keep clients safe. D) Use side rails instead of restraints, as appropriate.
A patient diagnosed with bipolar disorder commands other patients, "Get me a book. Take this stuff out of here," and other similar demands. The nurse wants to interrupt this behavior without entering into a power struggle
Which initial approach should the nurse select? a. Distraction: "Let's go to the dining room for a snack." b. Humor: "How much are you paying servants these days?" c. Limit setting: "You must stop ordering other patients around." d. Honest feedback: "Your controlling behavior is annoying others."