The nurse would anticipate that the patient with right-sided heart failure would exhibit
A) wheezing.
B) orthopnea.
C) edema.
D) pallor.
C
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The nurse is caring for a patient who recently suffered a cerebrovascular accident (CVA). The family asks the nurse why their father had a seizure. What is the best response by the nurse?
a. "The seizure was most likely caused by brain cells being deprived of oxygen due to a blood clot in the brain." b. "The stroke generated a toxin that excites the brain cells." c. "The stroke causes an alteration in the cells adjacent to the blood clot." d. "The stroke causes an increase in the de-polarization of the brain cells due to the clot formation."
Which of the following is an appropriate assessment activity for the nursing diagnosis, Risk for infection related to lowered immunity?
a. Wash hands frequently. b. Institute protective isolation. c. Practise medical asepsis. d. Check results of laboratory tests.
A burn victim is brought to the emergency room. While assessing this patient, the nurse notes that the patient's face is a cherry-red color. What should the nurse suspect?
A) Carbon monoxide poisoning B) Anemia C) Jaundice D) Uremia
The advanced practice registered nurse is leading a group therapy session. A group member talks incessantly and is disrupting the group's dynamics. Which response by the nurse encourages effective communication with the disruptive member?
1. "Why are you acting in this manner?" 2. "In one sentence, tell us what you want us to hear." 3. "It is important to consider the help that the group members are suggesting." 4. "What question can we ask that will make you want to participate in the group?"