A client has just been admitted to your unit with a diagnosis of Hodgkin's disease. When doing the initial assessment, what pertinent questions should the nurse ask the client to help determine the correct nursing diagnosis?
A) Are you experiencing fever, chills, or night sweats?
B) Do you use artificial respirators?
C) Have you ever had a blood transfusion?
D) Have you ever experienced fractures?
A
Feedback:
In a client with Hodgkin's disease, the nurse should ask how long the client has noticed the enlarged lymph nodes. The nurse checks for the presence and the extent of tenderness in the area of the lymph node enlargement. The nurse should also ask the client about fever, chills, or night sweats. It is not pertinent to ask the client about any previous history of fractures, the use of artificial respirators, or any blood transfusions.
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An older client has been reading about the use of melatonin for sleep. Which statement best indicates to the nurse that the client understands instruction about taking this supplement?
1. "Melatonin is a hormone my body makes on its own without intervention." 2. "Nausea is the worst side effect associated with melatonin." 3. "Older adults have reduced levels of melatonin and need a supplement." 4. "A melatonin dose should be taken a few hours before bedtime."
During a performance appraisal, Joanne, the nurse manager, indicates that Alysha has difficulty mentoring students on the unit. Alysha responds that this is not her responsibility. In responding to Alysha, Joanne needs to consider:
a. Alysha's level of confidence. b. Whether mentoring is included in the position description. c. Whether mentoring is an essential component of the position description. d. Whether mentoring can be accurately observed and measured.
To identify a patient or a resident:
a. Call the person by name b. Use the MSDS c. Use the ID bracelet d. Use the person's clothing
A client receiving insulin tells the nurse their blood glucose has been low the last few mornings. Which additional statement made by the client may be a contributing factor to the decrease in the blood glucose?
A. "I have been taking a garlic supplement to prevent colds." B. "I have been taking St. John's wort to help with my memory." C. "I have been taking extra vitamin C because so many people have colds." D. "I have been taking vitamin D to help build up my bones."