The nurse assessing a red blister over the right superior iliac area documents this decubitus ulcer as stage:
a. one.
b. two.
c. three.
d. four.
B
A pressure ulcer demonstrating blisters is a stage two decubitus ulcer.
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The employment setting in which the nurse is most likely to provide custodial care is the:
1. Hospital. 2. Extended-care facility. 3. Hospice. 4. Crisis center.
What is the nurse's priority assessment when administering narcotics to older adults? (Select all that apply.)
A) Central nervous system (CNS) effects B) Gastrointestinal effects C) Cardiovascular effects D) Urinary effects E) Developmental effects
A patient taking a drug for insomnia reports becoming sunburned even when only minimally exposed to the sun. What is your best action?
a. Ask the patient whether he or she usually burns when exposed to the sun. b. Instruct the patient to stop the drug and notify the prescriber immediately. c. Teach the patient to use sunscreen and wear protective clothing when outdoors. d. Document the report as the only action and reassure the patient that this problem is temporary.
The nurse prepares to administer a drug for heart failure to a patient. Which assessment finding does the nurse report to the prescriber before administering the drug?
a. Systolic blood pressure increase from 128 to 136 b. Urine output of 2100 mL in 24 hours c. Weight gain of 1 pound in 3 days d. Heart rate of 54 beats per minute