How many basic assessment techniques are there?
a. 4
b. 5
c. 6
d. 8
b
Inspection, palpation, percussion, auscultation and
olfaction are the five basic assessment techniques.
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A patient is admitted to the critical care unit with the diagnosis of massive head trauma caused by an MVA. The patient is unresponsive and on mechanical ventilation. EEG is negative for brain waves. The family has agreed to organ donation
The nurse turns the patient's head quickly from side to side. The eyes do not move. The nurse knows this is the result of a loss in the a. oculovestibular reflex. c. oculocephalic reflex. b. corneal and jaw reflexes. d. pupillary reflexes.
Which indicates the most important reason effective delegation is essential for nurses to practice and master?
1. Higher job satisfaction 2. Greater confidence in skills 3. Higher client satisfaction 4. Increased time for other tasks
Which instruction should the nurse give to a patient with pediculosis pubis?
A) "Use an over-the-counter lotion with permethrin." B) "Apply a second treatment of permethrin 7 days after the first treatment." C) "Wash all linens and towels in cold water." D) "Place items that cannot be washed in a garbage bag for one week."
The nurse is caring for a pt with a temp of 103 F, respirations of 30 per min., pulse rate of 50 beats per minute, and BP of 100/60. The pt is cold and clammy. What does the nurse conclude abt these findings?
a. The temp is causing a lowered pulse rate; it will improve if the temp. decreases. b. The low pulse rate is causing a decreased cardiac output, which has caused a low BP c. The pulse rate and BP are compensatory mechanisms to decrease the increased metabolic rate from the temp. d. The cool, clammy skin will help to increase the BP and pulse as the body tries to warm the skin