A nurse documents signs of Wernicke encephalopathy in a patient with long-term alcoholism. What do these signs include? (Select all that apply.)
a. Confabulation
b. Ataxia
c. Delirium
d. Decreasing level of consciousness
e. Projectile vomiting
A, B, C, D
The signs of Wernicke encephalopathy do not include projectile vomiting.
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Which patient statement indicates that more teaching is needed regarding antibiotic therapy for the treatment of cellulitis?
a. "My skin is cleared up. I don't think I need the medication anymore." b. "Cellulitis can come back at any time." c. "If I had washed that scratch with soap and water, I probably would not have gotten cellulitis." d. "Cellulitis is contagious."
The nurse in the emergency department assesses a 76-year-old female. The woman's bladder is visibly distended and the woman has not voided since the previous evening
Which of the following assessment questions made by the nurse is most relevant to the source of the woman's condition? A) "When was your last bowel movement?" B) "Have you been receiving hormone replacement therapy?" C) "What did you have to eat yesterday?" D) "Do you have a history of kidney disease?"
The nurse assessing a newborn recognizes that the most critical physiologic change required of the newborn is:
a. Initiation and maintenance of respiration b. Closure of fetal shunts in the circulatory system c. Maintenance of a stable temperature d. Full function of the immune system at birth
A nursing student has an assignment that requires looking up an article about nursing care following knee replacement surgery. The nursing student has only the title and the knowledge that the article was published within the last year
Which resource would be most helpful in completing the assignment? a. Education Index b. Materia Medicus c. Reader's Guide to Periodical Literature d. Cumulative Index to Nursing and Allied Health Literature