A patient arrives in the emergency department with a head injury. The patient is obviously in shock. A nurse should place the patient's bed in the
1. Fowler position.
2. Trendelenburg position.
3. Semi-Fowler position.
4. Flat position.
ANS: 2
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Which statement by a client's sibling would the nurse evaluate as meeting the goal of family education about mood disorders?
1. "I can't help but think he could get better if he tried." 2. "I feel so sorry for him. He is so pitiful." 3. "He is dealing with the effects of his illness as they occur." 4. "He never was very smart, and this has given him an excuse to be lazy."
The nurse is reviewing data for a patient with a wound. Which type of precaution would the nurse identify as needed by this patient?
1. contact 2. droplet 3. airborne 4. reverse
The nurse is assessing an 8-month-old infant for head lag, pulling the infant by the hands from a supine to a sitting position. The head does not stay in line with the body then being pulled forward
Which of the following statements best represents the significance of this finding? a. This is a normal finding, as the infant's head will not stay in line until after 8 months of age. b. The nurse has not conducted the test correctly and must do it again using proper technique. c. Significant head lag after the age of 6 months may indicate brain injury and needs further investigations. d. Head lag should not be tested until the child is over 1 year of age.
A nurse shines a light in the right pupil to test constriction and notices that the left pupil constricts as well. Based on these data, the nurse should:
a. Document this finding as an abnormal finding. b. Assess the client for accommodation. c. Document this finding as a consensual reaction. d. Assess the client's corneal light reflex.