A patient is demonstrating signs of thrombophlebitis. Which mechanism should the nurse expect has occurred with this health problem? Select all that apply.
A. Blood hypercoagulation
B. Vessel damage
C. Pooling of blood in the vessel
D. Elevated systemic blood pressure
E. Stasis of blood flow
Answer: E
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During the assessment of the integumentary status the nurse determines that an older client is experiencing age-related skin changes. What did the nurse assess to make this clinical decision? (Select all that apply.)
1. Gray hair 2. Thick yellow peeling nails 3. Ecchymosis over bilateral thighs 4. Pustules on the lower neck region 5. Petechiae scattered over the forearms
The LPN is working with a team of nurses in order to develop protocols for managing care of clients who are having peritoneal dialysis on their unit. What type of care mapping would the nurse use for the development of these standards?
A) Nursing care plan B) Standing orders C) Recipe for care D) Clinical pathways
A client with a sleep disorder experiences cataplexy. Which is a feature of this condition?
A) Irresistible urge to sleep, regardless of the type of activity in which the client is engaged B) Sudden loss of motor tone that may cause the person to fall asleep; usually experienced during a period of strong emotion C) Nightmare or vivid hallucinations experienced during sleep time D) Skeletal paralysis that occurs during the transition from wakefulness to sleep
Which actions exemplify the school nurse's role as a child advocate? (Select all that apply.)
A) Injecting a child with her EpiPen during an anaphylactic reaction to peanuts B) Convincing the cafeteria manager to include low-sugar options in the lunch menu for students with diabetes C) Taking the temperature of a child who is exhibiting signs of an upper respiratory infection D) Teaching a child who has recently been diagnosed with asthma how to use an inhaler E) Instructing a group of faculty members on the proper way to respond to a child having an epileptic seizure in class