The nurse is gathering objective information about a client demonstrating depression. What should the nurse note about this client?
1. The client admits to loneliness.
2. The client walks erect with a bounce.
3. The client is wearing clean, pressed clothes.
4. The client walks with a shuffling gait.
Answer: 4
1. An admission of loneliness by the client is subjective datum.
2. The client who walks erect and bounces is exuding confidence or happiness.
3. The client who is well-dressed cares about appearance, which is a normal, healthy behavior.
4. A shuffling gait is characteristic of a depressed attitude.
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A 36-year-old African-American patient has been admitted to the hospital with diabetic ketoacidosis. The nurse who is admitting him notes that his blood pressure is 164/98 . Which of the following should the nurse do next?
a. Call the health care provider because the patient's values differ from the standard range. b. Immediately call the health care provider and request antihypertensive medication. c. Ask the patient what his blood pressure normally measures for comparison. d. Do nothing; this is within a normal range for a patient with diabetic ketoacidosis.
A client with appendicitis has an appendectomy. After surgery, what type of pain does the nurse anticipate the patient will have?
A) Acute pain B) Chronic pain C) Neuropathic pain D) Referred pain
The nurse is admitting to the unit a client who is a 42-year-old female with a COPD exacerbation
While doing the admission assessment, the nurse finds out that this client is being treated for depression and has had little or no appetite for over a month. What type of diet would be planned for this client? A) High-calorie, high-protein meals three times a day B) Small frequent meals spread out over the day C) Regular diet with vitamin and mineral supplements with the meals D) High-fiber diet with enteral supplements between the three meals
While obtaining the health history, it is important for the nurse to ask the client about the use of herbal products, over-the-counter remedies, and dietary supplements because:
1. they should be stopped during admission to the hospital. 2. they should be increased during a time of illness. 3. these are not important items to talk about and should not be asked about. 4. these products may have potential interactions with medications that are being prescribed.