Which of the following client problems is considered a nursing diagnosis?
A. Blindness related to the inherited recessive disorder retinitis pigmentosa
B. Risk for injury related to decreased central vision
C. Potential for blindness related to bilateral eye infection
D. Psychotic reaction related to deteriorating visual acuity
B
Answers A and D are medical diagnoses. Answer C is a collaborative problem. Only B is a client problem in regard to a response to illness or disability and can be helped by nursing interventions.
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A young adult client is admitted to the psychiatric unit after a suicide attempt. The nurse learns that the client recently escaped from a domestic violence situation and was sexually abused by a parent as a child
The nurse observes that the client has numerous cuts up and down both arms and legs. After more discussion, the nurse writes the following diagnosis in the client's care plan: Self-mutilation related to need to end dissociative experiences, secondary to sexual abuse. What did the client say that was evidence for this diagnosis? A) "Cutting myself was the only way I could get admitted to the hospital.". B) "I cut when I get angry at myself; it feels like something I deserve.". C) "When I cut myself I feel alive, not like a lump of dead meat.". D) "I have periods where I feel like I am living in a dream or walking through a fog and cutting helps me refocus.".
The patient receives metaproterenol (Alupent), an adrenergic drug. A consulting physician orders carteolol (Cartrol), a beta blocker. What best describes the nurse's assessment?
1. The patient is at risk for a hypertensive crisis. 2. The effects of metaproterenol (Alupent) will be decreased. 3. The drugs are compatible; there will not be any adverse effects. 4. The effects of metaproterenol (Alupent) will be increased.
For what sort of needs do nurses assist families? Select all that apply
A. Providing anticipatory guidance for growth and development needs B. Assisting families with coping with illness or loss C. Explaining the family's situation to the media so others may offer assistance D. Helping families cope with stressors or a crisis E. Referring families to sources of assistance or support F. Obtaining funds or supplies for the family in need
The nurse is caring for an active 14-year-old boy who has recently been diagnosed with scoliosis. He is dismayed that a "jock" like himself could have this condition, and is afraid it will impact his spot on the water polo team
Which response by the nurse would best address the boy's concerns? A) "If you wear your brace properly, you may not need surgery." B) "The good news is that you have very minimal curvature of your spine." C) "Let's talk to another boy with scoliosis, who is winning trophies for his swim team." D) "Let's talk to the doctor about your treatment options."