A patient has cancer of the liver and has a percutaneous biliary drainage system. Which of the following assessments should the nurse record on the patient's data sheet?
A) Amount and color of drainage
B) Temperature of drainage
C) Odor of drainage
D) Consistency of drainage
Ans: A
Feedback: The percutaneous biliary system is open to external drainage. The bile is observed closely for the amount, color, and presence of blood and debris.
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A nurse is interviewing a patient being admitted to the hospital for surgery. During the interview, the nurse introduces self and explains that will be gathering some information. The nurse is in which phase of the interview?
a. Orientation b. Working c. Assessment d. Termination
When developing a plan of care for the patient receiving a glucocorticoid, what nursing diagnosis would be of highest priority?
A) Deficient fluid volume related to water retention B) Risk for injury related to muscle weakness C) Imbalanced nutrition: less than body requirements D) Risk for infection related to immunosuppression
The nurse is assessing the client and notes low-pitched, continuous respiratory sounds that have a snoring quality while auscultating the client's lungs. Which term would the nurse use when documenting this finding?
1. Rales. 2. Crackles. 3. Rhonchi. 4. Wheezes.
Your manager has asked to do some research on evidence-based best practices for pediatric nursing specific to leukemia that may be incorporated into guidelines for your pediatric oncology unit
Using the P-F-A Internet search technique, which of the following is not one of the questions/search guidelines you might use pertaining to the focus aspect of this Internet search? a. narrow and technical with research orientation b. are you preparing information to give to patients or families? c. lay-oriented or professionally orientated? d. broad and general (basic information for yourself)?