The nurse is assessing a new home health client. What observation would be relevant for a cultural assessment?
a. The client asks the nurse how to obtain assistance with his utility bills.
b. The client's wife reports that the children are having difficulty in school.
c. The client tells the nurse that he would like to move into public housing.
d. The client's wife corrects the husband's response to questions about his parents.
D
Interaction among family members can give important clues to culture and cultural influence. In many cultures, the husband is the authority of the household and wives do not express opinions or question the validity of the husband's statements. But in this case, the wife seems to have the ability to give constructive criticism. The other responses do not reflect any specific aspects of an individual's beliefs, values, customs, norms, or habits.
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When assessing the patient with pericardial effusion, the nurse will assess for pulsus paradoxus. Pulsus paradoxus is characterized by:
A) A diastolic blood pressure that is lower during exhalation B) A diastolic blood pressure that is higher during inhalation C) A systolic blood pressure that is higher during exhalation D) A systolic blood pressure that is lower during inhalation
Which factors are absolute contraindications for thrombolytic therapy? (Select all that apply.)
a. Active peptic ulcer disease b. Active internal bleeding c. Recent head trauma d. Endocarditis e. Suspected aortic aneurysm f. Surgery within the last 10 days
When the group decides to have a "congratulations" cake at its last session, you recognize that this serves as a:
a. transitional ritual akin to graduation b. mechanism for members to thank you c. counterproductive blocking maneuver d. way to avoid working on issues
A nurse overhears a student discussing the treatment of fluid volume deficit. The nurse intervenes when the student says:
1. "Fluid volume deficit requires the rapid infusion of intravenous (IV) fluids." 2. "The patient's urinary output will initially be absent or less than the intake, but should gradually increase as the patient becomes more hydrated." 3. "If the source of loss is from the gastrointestinal (GI) tract, antiemetic medications may be ordered for nausea or vomiting." 4. "Once the patient is able to tolerate oral fluids, a clear liquid diet advanced as tolerated is generally ordered."