The nurse is caring for a patient with a history of asthma who is newly diagnosed with hyperthyroidism. What assessment finding should the licensed practical nurse (LPN) report immediately to the registered nurse (RN)?
a. Heart rate 112 beats/min
b. Temperature 97.2°F (36.2°C)
c. Blood pressure 112/73 mm Hg
d. Respiratory rate 20 breaths/min
ANS: A
A heart rate of 112 beats per minute is abnormal. B. C. D. All the other vital signs are normal.
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The following documentation was written on a chart: ?The client was found lying on the floor. Dr. X was notified. Apparently the restraints were improperly applied.? Which statement best describes this documentation? The documentation is:
1. Appropriately written. 2. Inappropriate because it places blame on an individual. 3. Inappropriate because it does not include that the client was notified. 4. Appropriately written because it only documents the facts.
A patient complains of occasional periods of confusion and forgetfulness but reports a clear thought process most of the day. The symptoms have been gradually worsening. What is the best initial response by the nurse?
1. "Have you started any new medications?" 2. "You probably have nothing to worry about. It's most likely stress-related.". 3. "Everybody has a few problems with memory as they get older.". 4. "You should probably have an MRI of your brain.".
A client is diagnosed with a communicable disease, and must be placed in isolation. The nurse should identify which diagnosis as a priority for this client?
1. Social Isolation 2. Anxiety 3. Acute Pain 4. Imbalanced Nutrition: Less Than Body Requirements
A nurse is educating a class of active, 21-year-old male college students about how many calories a day they require to maintain their current body weights. The nurse recommends approximately
1. 1200 calories a day. 2. 1800 calories a day. 3. 2400 calories a day. 4. 3000 calories a day.