The nurse would be most concerned about which of the following indicators of a client's nutritional state?
1. serum albumin level of 3.5 g/dL
2. hematocrit of 38%
3. current weight of 101 lb, down from 120 lb 6 months ago
4. sores in the corners of the client's mouth
ANS: 3
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The nurse is assessing a newborn. The parents are present. Which statement is best?
1. "Your infant was born with several reflexes. Some help her eat and protect her. I will show you what they look like." 2. "You will be most successful if you put your baby to breast when she has her eyes wide open and she is looking around." 3. "The muscle tone of your baby will increase as she gets older. You'll notice her head lagging less in a few weeks." 4. "The umbilical cord stump will dry up and fall off in about two weeks. There might be a spot of blood when it falls off."
A researcher who has conducted experimental research finds that in his 145-person hospital study the patients who are ambulated on the evening of abdominal surgery are less likely than the control group to develop postoperative pneumonia
What does the researcher infer? a. The control group resembled the experimental group in all important characteristics. b. Early ambulation and pneumonia are strongly related. c. Evening-of-surgery ambulation will prevent some cases of postoperative pneumonia in abdominal surgery patients. d. Careful support of the abdomen is important for postoperative ambulation in patients who have had abdominal surgery.
The pediatric nurse beginning the morning shift learns during report that an infant may have a heart murmur. Where on the infant's chest will the nurse auscultate for heart sounds?
A) At the second and fifth right and left intercostal spaces and apex area B) At the first and fourth right and left intercostal spaces, axillae, and apex areas C) At the third and fourth right and left intercostal spaces, apex, and clavicular areas D) At the second and fourth right and left intercostal spaces, apex, and axillae areas
When providing care for a postoperative patient, it is important for the nurse to include which postoperative exercise?
a. Turning every 4 hours b. Completing leg exercises once daily c. Repeating individual leg exercises 20 times d. Performing exercises with the unaffected extremities