When assisting the older adult who is despondent about the need to leave his home, what technique should the nurse use?
a. Ask him if he has a drinking problem
b. Explore the option of his moving in with someone
c. Reminisce with the patient and review his life
d. Assess for hopelessness and helplessness
ANS: C
Reminiscence and life review are effective techniques to help older adults deal with changing life circumstances.
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The nurse assesses a patient with a surgical incision. What is an expected patient outcome on the fourth postoperative day?
a. The tympanic temperature is 39.5° C at 8 AM and noon. b. The incision is slightly reddened and swollen without drainage. c. The skin is spongy and warm around the incision. d. The patient's pain has been increasing gradually.
In which of the following situations should the nurse use surgical asepsis?
a. Performing urinary catheter care b. Inserting a nasogastric tube c. Inserting a Foley catheter d. Performing nasogastric tube care
The nurse is preparing to initiate a blood transfusion. Which step of the procedure should the nurse implement first?
a. Begin the infusion at 2 mL/min. b. Establish a single-line infusion. c. Check vital signs in 30 minutes. d. Shake the blood gently to mix the preser-vative.
The client has been started on Elavil. He tells the nurse that he does not take any other medication except for St. John's wort, which he has found to be mildly therapeutic
What should be the nurse's highest priority response to this information? a. The combination of Elavil and St. John's wort can be particularly therapeutic. b. Use of St. John's wort can cause the dosage of Elavil to require increase. c. Use of St. John's wort can cause the Elavil to be completely ineffective. d. The combination of St. John's wort and Elavil can produce serotonin syndrome.