A client with hemophilia has a very swollen knee after falling from bicycle. Which of the following is the first nursing action?
a) initiate an IV site to begin administration of cryoprecipitate
b) type and cross-match for possible transfusion
c) monitor the client's vital signs for the first 5 minutes
d) apply ice pack and compression dressings to the knee
Ans: d) apply ice pack and compression dressings to the knee
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A 59-year-old patient is being assessed for hypoparathyroidism. The nurse should anticipate that this patient is likely to require what diagnostic test?
A) CT of the abdomen B) Bone density testing C) Cardiac stress testing D) 24-hour urine
While assessing the dorsalis pedis pulse of a client, the nurse determines that the pulse is absent. However, the extremity is warm and pink with nail beds blanching at 2 to 3 seconds of capillary refilling time
How would the nurse explain these findings? 1. A change in the client's health status has occurred. 2. The client has thrown a blood clot in that extremity. 3. The RN's watch has stopped working. 4. Too much pressure was applied over the pulse site.
A nurse is working with a patient who has been diagnosed with a somatoform disorder. The patient asks, "My last tests didn't show anything. When will I have more diagnostic testing?" Which nursing response would be most therapeutic?
a. "You are resisting the idea that you do not have a physical illness.". b. "No more tests will be ordered. Your health maintenance organization (HMO) won't pay for repeating any tests.". c. "We think you need a rest from all the testing. We'll consider more tests at a later time.". d. "Since the tests were all negative, we will focus next on evaluating the role of stress in your life.".
A patient's finger stick blood sugar registers 70. The nurse must follow the policy and procedure for caring for a patient with hypoglycemia. This is an example of what type of decision-making process?
1. Programmed decision-making 2. Crisis decision making 3. Time-limited decision making 4. Non-routine decision-making