Hydrocephalus is suspected in a 4-month-old infant. Which of the following would the nurse expect to assess?
A) Sunken fontanels
B) Diminished reflexes
C) Lower extremity spasticity
D) Skull symmetry
C
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A nurse made a home visit for prenatal care and teaching for an Asian woman. The nurse noted the woman was having a hot lunch of foods the nurse did not recognize
When the nurse suggested some appropriate cold protein foods be added to the meal, the woman looked horrified and distrusting. Which of the following best describes what has happened in this situation? a. The interference with eating seemed incredibly intrusive and inappropriate. b. The nurse was giving advice when advice had not been sought. c. The nurse had suggested foods unknown to the woman. d. The yin and yang theory requires only hot food be eaten when female yin energy is dominant.
Which type of neuron would the nurse expect to be blocked first a local anesthetic is used?
a. Pain perception b. Perception of cold c. Touch d. Deep pressure
The patient is experiencing uterine contractions lasting approximately 100 seconds each. What action by the nurse is most appropriate?
a. Notify the charge nurse. b. Turn the patient onto her right side. c. Administer oxygen by nasal cannula to the patient. d. Help the patient go for a brief walk.
Which of the following is a correctly written example of a short-term goal?
a. By attending the gym, the patient will lose 50 lb in 1 year. b. In 6 months, patient will be able to ambulate 1 mile without shortness of breath. c. Patient will be able to change his colostomy bag within 6 weeks of surgery. d. With diet and exercise, the patient will lose 1 lb this week.