Mr. Phelps is in the ICU after a ruptured cerebral aneurysm. During the nurse's assessment, it is noted that Mr. Phelps has new onset of hemiparesis, is slightly lethargic and difficult to arouse, and when awake complains of diplopia
These symptoms suggest
A) a rebleed of the aneurysm.
B) increased intracranial pressure.
C) vasospasm.
D) carbon dioxide retention.
C
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The nurse is teaching progressive muscle relaxation techniques to the client. Which rationale will the nurse include in the teaching session for progressive muscle relaxation?
1. It is a form of diversion that keeps your mind off of your stress. 2. By releasing muscle tension, the negative effects of stress can be lessened. 3. By relaxing the muscles, the pain the client is experiencing will cease. 4. It is a good form of exercise that will help you get into better shape so you won't experience any more pain.
A female client, prominent in the local media, has had surgery for a colostomy. The client avoids looking at the colostomy and refuses visitors. Identify the most appropriate nursing diagnosis
A) Altered self-esteem related to colostomy and poor self-image B) Disturbed body image related to colostomy as evidenced by avoidance of colostomy C) Fear of rejection by others related to colostomy and altered self-image D) Altered role performance related to inability to cope with visitors
A patient prescribed highly active antiretroviral therapy (HAART) is flying to a wedding and will be gone 1 day. The patient asks about skipping prescribed drug doses that day in order to avoid having to show them all at the airport
What is the nurse's best response? a. "Yes, just one day off your drugs will not make any difference." b. "Yes, as long as you avoid direct contact with anyone who is ill." c. "No, even one day off the drugs can help the virus become drug resistant." d. "No, even one day off the drugs increases the chance that you can spread the dis-ease."
Community partnership is necessary because lay members often have a vested interest in the success of efforts to improve the health of their community. Most changes should
1. Involve the community residents only 2. Use nurses as their source of information and leadership 3. Rely on the power of local officials 4. Include a variety of disciplines