The nurse is assessing a patient who is admitted with possible delirium. Which of these are manifestations of delirium? Select all that apply
a. Develops over a short period.
b. Person is experiencing apraxia. c.
Person is exhibiting memory impairment or deficits.
d. Occurs as a result of a medical condition, such as systemic infection.
e. Person is experiencing agnosia.
ANS: A, C, D
Delirium is a disturbance of consciousness that develops over a short period and may be attributable to a medical condition. Memory deficits may also occur. Apraxia and agnosia occur with dementia.
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Assessment of a patient with pericarditis may reveal which of the following signs and symptoms?
a. Ventricular gallop and substernal chest pain b. Narrowed pulse pressure and shortness of breath c. Pericardial friction rub and pain d. Pericardial tamponade and widened pulse pressure
While assessing a typical patient with cholecystitis who complains of localized pain, the nurse asks if the pain has radiated to the:
A) Left upper arm B) Lower abdomen C) Neck or jaw D) Right shoulder
A patient is recovering from a myocardial infarction but does not have symptoms of heart failure. The nurse will expect to teach this patient about:
a. ACE inhibitors and beta blockers. b. biventricular pacemakers. c. dietary supplements and exercise. d. diuretics and digoxin.
The SBAR system of communications is one of the most used communication systems in health care because:
a. It deals with all aspects of communications in patient care except communication with the physician. b. The nurse is on the same communication level as administration. c. It honors a familiar, structured transfer of information among health professionals. d. It honors an unstructured transfer of information.