The nurse is visiting a patient who lives alone in a two-room house. The patient requires wound care and medication management, but his health is not expected to improve much, even with care
There is no running water in the house, and the bathroom is in disrepair and filthy. At the first home visit, which of the following should the nurse assess? Select all that apply.
a. Wound status
b. Patient concerns
c. Ability to perform care independently
d. End-of-life planning
ANS: A, B, C
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MC When administering an enema to a child rather than an adult, the major difference is to
A. Insert the enema tube 2-3 inches. B. Instill 50—100 mL of solution. C. Instill solution from a height of 6 inches. D. Place the child on his or her right side.
Which problem or manifestation in a 125-pound, 40-year-old woman, 1-day postoperative for a total abdominal hysterectomy, leads the nurse to suspect possible substance abuse?
A. She has vomited nine times during the first 24 hours after surgery. B. Morphine 15 mg (subcutaneous) has failed to relieve her pain. C. She has been unable to void after removal of the Foley. D. Her wound drainage is greater than expected.
A patient, admitted with general malaise, nausea, and vomiting, tells the nurse that he started to feel sick a few weeks after getting a new tattoo on his leg
Which of the following types of hepatitis should the nurse suspect is causing this patient's symptoms? 1. A 2. B 3. C 4. D
A first-time mother calls the clinic to talk to the nurse. The mother is very upset, saying that her newborn's fingernails dip in the middle, appearing spoon-like. What would be the nurse's best response?
A) "Take the baby to the emergency room to be evaluated." B) "Bring your baby to the clinic immediately." C) "This may be normal in infants." D) "This is a sign of a nutritional deficiency. What are you feeding your infant?"