The patient has a peripheral vascular ulcer that involves loss of the epidermis, dermis, and subcutaneous tissue. Muscle and tendons are visible at the deepest part of the wound. How does the nurse classify this wound?
A) Stage II
B) Stage III
C) Superficial
D) Full-thickness
D
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Which of the following observations of a postpartum client would be most alarming?
A) Intermittent heartburn after meals B) Sharp chest pain when client burps C) Catching-type pain with deep breaths D) Sharp stabbing chest pain with shortness of breath
Prior to discharge, a patient with diabetes needs to learn how to check a finger-stick blood sugar before taking insulin. Which action will best help the patient remember proper technique?
1) Encouraging the patient to check the blood sugar each time the nurse gives insulin 2) Providing feedback after the patient takes his blood sugar for the first time 3) Verbally instructing the patient about how to obtain a finger-stick blood sugar 4) Offering a brochure that describes the technique for checking a blood sugar
The nurse is reviewing laboratory results for a
patient and notes that the patient has positive results for nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). The nurse anticipates an order for which medication? a. Acyclovir (Zovirax) b. Mupirocin (Bactroban) c. Clindamycin (Cleocin T) d. Clotrimazole (Lotrimin)
The nurse is caring for a client being weaned from the ventilator, and wants to improve the client's ability to communicate. Which item should the nurse request an order for from the health care provider?
1. Cuffed tracheostomy tube 2. Uncuffed tracheostomy tube 3. Fenestrated tracheostomy tube 4. Obturator