Sara Simpson, 69 years old, has had a cerebrovascular accident that has affected her ability to move and ambulate. Which of the following interventions would be part of her plan of care?
a. Encourage her to transfer without assistance to determine ability to transfer
b. Encourage her to ambulate without assistance to determine walking ability
c. Perform passive range of motion to all joints
d. Encourage weight-lifting exercises to increase strength
D
Performing weight-lifting exercises is the most appropriate intervention. Responses A and B are inappropriate and could place Mrs. Simpson at risk for falls. Response C does not encourage active participation of Mrs. Simpson in her rehabilitation plan of care.
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A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative
Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions? 1. Sedative-hypnotics are potentially addictive, and their effectiveness will be compromised owing to tolerance. 2. Sedative-hypnotics are expensive and have numerous side effects. 3. Sedative-hypnotics interfere with necessary REM (rapid eye movement) sleep. 4. Sedative-hypnotics are known not to be as effective in promoting sleep as antidepressant medications.
The mother of a 1-month-old infant calls the nurse who works in the health clinic. The mother is concerned because the infant has had vomiting and diarrhea for 1 days
The nurse knows that this infant is at risk for metabolic acidosis. Which is the priority nursing action? A) Instruct the mother to provide the infant with 50 mL of glucose water. B) Instruct the mother to measure the infant's urine output for 24 hours. C) Instruct the mother to give the infant at least 2 ounces of juice every 2 hours. D) Instruct the mother to bring the infant to the clinic for evaluation.
The cultural pattern highly valued in American society that often results in nurses of the dominant
culture establishing unrealistic outcomes for clients of other cultural groups is a. interdependence. b. present orientation. c. using direct confrontation to solve problems. d. suspending one's own needs in favor of external obligations.
A nursing instructor is describing parkinsonism to a group of nursing students. The instructor determines that the teaching was successful when the students identify which of the following as a possible cause? Select all that apply
A) Drugs B) Stroke C) Myocardial infarction D) Encephalitis E) Epilepsy