The nurse is assessing the eyes of an older adult client. Which finding is expected by the nurse based on the client's age?
1. The client is easily able to read from a paper held at close range without corrective glasses.
2. There is a noticeable increase in fat within the orbit of the eye.
3. The client states that she feels her tear production has increased over the years.
4. The pupillary light reflex is slower bilaterally.
Correct Answer: 4
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Using an IV infusion system that delivers 60 drops/mL, the nurse hangs a 500-mL bag of NS at 8 AM. The physician has ordered a rate of 20 mL/hr. The nurse will set the roller clamp to deliver:
1. 10 gtts/minute. 2. 20 gtts/minute. 3. 25 gtts/minute. 4. 30 gtts/minute.
A nurse caring for a client admitted to the intensive care unit with a stroke assesses the client's vital signs, pupils, and orientation every few minutes. The nurse is performing which type of assessment?
A) Initial assessment B) Focused assessment C) Time-lapsed reassessment D) Emergency assessment
The nursing student is caring for an infant with a respiratory infection and is monitoring for signs of dehydration. The nursing instructor asks the student to identify the most reliable method of determining fluid loss
The instructor determines that the student understands this method when the student states that the plan is to: 1. Monitor output. 2. Monitor body weight. 3. Assess the mucous membranes. 4. Obtain a temperature every 2 hours.
A normal birth by definition in this chapter is a spontaneous vaginal birth without epidural analgesia intrapartum
Indicate whether the statement is true or false.