A 7-month-old infant weighs 11.6 lb compared with a birth weight of 7.1 lb and has a head circumference of 19 inches. What does the nurse document about this infant?
a. Underweight and normal head circumference
b. Underweight and larger-than-normal head circumference
c. Overweight and smaller-than-normal head circumference
d. Normal weight and larger-than-normal head circumference
ANS: B
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Select the instructions by the nurse that would best prevent postoperative complications in a client who has just undergone a stapedectomy for a bone-conduction hearing loss
a. Leave the mouth open when sneezing. b. Use a soft, cotton-tipped applicator to clean the blood and drainage from the af-fected ear to prevent infection. c. Bend over very slowly during the first 48 hours post-operation. d. Keep the head of the bed flat for the first 24 hours.
The nurse is preparing to present a teaching session on skin protection for a group of older adults at a senior center. A principle that has been found to be most effective in teaching older adults is:
1. Moving the group along at a predetermined pace 2. Providing information in longer teaching sessions 3. Speaking very slowly and in a louder tone of voice 4. Beginning and ending each session with important information
State the five main functions of the gastrointestinal system.
What will be an ideal response?
A home health nurse is visiting a patient who has been taking the same dose of hydrocodone/acetaminophen (Lortab) for 2 months. To monitor for the presence of expected side effects of this medication, what should the nurse include in the assessment of the patient?
a) Ask about the patient's bowel pattern. b) Observe respiratory rate and depth. c) Assess level of consciousness. d) Take the patient's blood pressure.