The nurse is caring for an older adult patient. While auscultating the patient's apical pulse, the nurse notices an irregular rhythm. The nurse suspects which causative factor for the patient's dysrhythmia?
a. Loss of cells in the sinoatrial (SA) nodes
b. Increased peripheral resistance
c. Hypertension
d. Atherosclerosis
A
Loss of cells in the SA nodes via age-related changes is the most common cause of dysrhythmias in the older adult. This nurse should, however, document these findings and report the findings to the primary care provider.
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A 50-car pileup occurs on a major freeway in California's Central Valley as a result of heavy fog. There are major injuries, and victims are expected to be transported to local emergency depart-ments. Which type of disaster is this classified as?
a. Mass casualty event b. Conventional disaster c. Biological disaster d. Radiological disaster
After examining a young woman, the nurse asks her questions about some bruises on her back. The client confides that her husband has started hitting her when they argue
The nurse makes recommendations about getting help; the client dismisses them and states, "It's just a few bruises. I think I can handle it." Which long-term consequences of exposure to violence, according to Healthy People 2020, should the nurse discuss with this client? (Select all that apply.) A) Premature death B) Breast cancer C) Disability D) Lost productivity E) Obesity
Mrs. Yamada has been admitted to the psychiatric unit because of her worsening diagnosis of major depression that has not responded appreciably to treatment. In light of Mrs. Yamada's statement that "everything would be better if I was just dead and gone,
the nurse would be justified in identifying what type of nursing diagnosis related to suicide? A) Risk nursing diagnosis B) Wellness nursing diagnosis C) Actual nursing diagnosis D) Syndrome nursing diagnosis
The nurse is caring for a patient in the hospital who is visually impaired. Which of the following nursing considerations would be appropriate for this client? Select all that apply
A) Let the client know when you are leaving the room. B) Speak in a louder tone to compensate for loss of vision. C) Touch clients before speaking to them to keep from frightening them. D) Identify self when entering the room. E) Place food on the plate in a "clock position" and identify the food. F) Lightly push the client from behind when helping the client to ambulate.