The nurse is teaching the family of clients with Alzheimer's disease about the disease process. The nurse is using a picture of the brain and highlighting which structures?
A) Neurotransmitters and cell receptors
B) Neurofibrillary tangles and amyloid plaques
C) Brain tissue and receptor sites
D) Blood vessels with valves
B
Feedback:
The nurse is most correct to instruct the families on neurofibrillary tangles and amyloid plaques. These are characteristic in clients with Alzheimer's disease. The other options may have some effect related to the disease but are not characteristic.
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The nurse caring for a patient recently admitted with acute pancreatitis. Which action(s) should the nurse include in the daily assessments? (select all that apply.)
a. Auscultate bowel sounds. b. Carefully evaluate amount of food eaten each meal. c. Measure abdominal girth. d. Monitor for effectiveness of pain control. e. Monitor urine output.
With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?
a. The nurse did not document fetal heart tones (FHR) during the second stage of labor. b. The client was only provided ice chips during the labor period, which lasted 8 hours. c. The nurse allowed the client to use the bathroom rather than a bedpan during the first stage of labor. d. The nurse asked family members to leave the room when she prepared to do a pelvic exam on the client.
Which serum electrolyte value in a client with polycythemia vera should the nurse report to the physician?
A. Sodium, 132 mEq/L B. Chloride, 98 mEq/L C. Potassium, 7.2 mEq/L D. Total calcium, 8.7 mg/dL
The greatest share of the responsibility of discharge planning for the patient receiving restorative nursing care falls on the
a. social worker and nurse b. physician and physical therapist c. rehabilitation center administrator and physician d. nurse and physical therapist