A nursing student is caring for a 77-year-old Hispanic woman. The nurse's preceptor asks the student what would be an important assessment to make to provide quality nursing care for this client
What would be the student's most appropriate response?
A) Transcultural assessment
B) Respiratory assessment
C) Mobility assessment
D) Family assessment
A
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When caring for a patient with toxic epidermal necrolysis you know that it is important to assess frequently for high fever, tachycardia, and extreme weakness and fatigue as these are indicative of what? (Mark all that apply.)
A) A comorbid infection B) Epidermal necrosis C) Impending death D) Increased metabolic needs E) Possible gastrointestinal mucosal sloughing
A hospitalized client tells the registered nurse (RN) that a living will is being prepared and that the lawyer will be bringing the will to the hospital today for witness signatures
The client asks the RN for assistance in obtaining a witness to the will. The most appropriate response to the client is which of the following? 1. "I will sign as a witness to your signature." 2. "You will need to find a witness on your own." 3. "Whoever is available at the time will sign as a witness for you." 4. "I will call the nursing supervisor to seek assistance regarding your request."
A client diagnosed with bipolar I disorder is exhibiting severe manic behaviors. A physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The client's spouse questions the Zyprexa order. Which is the appropriate nursing reply?
A. "Zyprexa in combination with Eskalith cures manic symptoms." B. "Zyprexa prevents extrapyramidal side effects." C. "Zyprexa ensures a good night's sleep." D. "Zyprexa calms hyperactivity until the Eskalith takes effect."
A licensed practical/vocational nurse (LP/VN) is caring for a resident who has orders providing supervised smoking of cigarettes in the smoking area. The LP/VN rounds and smells smoke
He enters the client's room and finds the resident sitting up in bed and smoking while on a nasal cannula at 2 L/minute of oxygen. He has caught the top blanket of two blankets on fire (a small area of the blanket, 3 × 2 inches). Which priority action should the nurse provide? A) Throw the full water pitcher onto the fire. B) Turn off the oxygen concentrator; grab the cigarette, and put it in the sink next to the bed with running water. C) Remove the blanket and place into sink with running water. D) Call for help and assess and treat client.