The patient with a suspected subdural hematoma is on an intravenous (IV) drip of mannitol infusing at 50 mL/hr. The nurse explains that the slow infusion rate is essential for what purpose?
a. To ensure effectiveness of the drug.
b. To avoid fluid overload.
c. To maintain electrolyte balance.
d. To maintain adequate blood pressure (BP).
B
The slow infusion rate will not cause fluid overload, which would add to the possibility of in-creased intracranial pressure (ICP).
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The patient, diagnosed with angina, tells the nurse he is having chest pain. There is an order for oral sublingual nitroglycerin as needed. What action should the nurse take?
A) Place two nitroglycerin tablets under the patient's tongue and call the physician. B) Place one tablet under the patient's tongue and repeat every 5 minutes for total of three tablets until pain has been relieved. C) Have the patient swallow a tablet with a full glass of water and repeat in 10 minutes. D) Apply a nitroglycerin transdermal patch to the patient's back.
As a nurse in labor and delivery, you are caring for a Muslim woman during the active phase of labor. You note that when you touch her, she quickly draws away. You should:
a. continue to touch her as much as you need to while providing care. b. assume that she doesn't like you and decrease your time with her. c. limit touching to a minimum, as physical contact may not be acceptable in her culture. d. ask the charge nurse to reassign you to another client.
Which assessment indicates that a client is in true labor?
a. Mucous plug expelled 1 hour ago b. Cervical changes noted from last exam 2 hours ago c. Frequency of the contractions decreases with rest d. Pain centered in the abdominal area only
Xeropthalmia or hard dry cornea is caused by a severe deficiency in which vitamin?
a. vitamin A c. vitamin D b. vitamin C d. vitamin E