The registered nurse should modify the plan of care for a client when:

a. the outcomes are partially met.
b. the goal has been met.
c. the data indicate a lack of progress toward goal achievement.
d. data has been omitted in the assessment phase.


ANS: C

Nursing

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A nurse cares for a client after a pituitary gland stimulation test using insulin. The client's post-stimulation laboratory results indicate elevated levels of growth hormone (GH) and adrenocorticotropic hormone (ACTH). How should the nurse interpret thes

a. Pituitary hypofunction b. Pituitary hyperfunction c. Pituitary-induced diabetes mellitus d. Normal pituitary response to insulin

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A postanesthesia care nurse is evaluating a patient for possible transfer to the surgical unit. Which assessment should prevent the patient's transfer?

a. Blood pressure of 126/78 mm Hg b. Pulse rate of 82 beats/min c. Pulse oximeter reading of 85% d. Respirations of 22 breaths/min

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A patient with diabetes is surprised to learn that he has been having angina when the only problem he has been experiencing is a "bit of fatigue and shortness of breath."

Which of the following should the nurse explain to this patient? 1. fatigue is the first symptom of angina 2. shortness of breath is the first symptom of angina 3. the diabetes has caused you to have reduced pain sensitivity so the fatigue and shortness of breath were the symptoms that you felt 4. there is no classic symptom of angina

Nursing

James Fuller, aged 57, has a history of alcohol dependence. He has been admitted to a detoxification unit

He has tremors, he is anxious, his pulse has risen from 98 to 110, his blood pressure has risen from 140/88 to 152/100, and his temperature is six tenths of a degree above normal. He is slightly diaphoretic. Which of the following would be a priority nursing diagnosis for Mr. Fuller? A) Hallucinations B) Risk for injury C) Ineffective coping D) Denial of problems

Nursing