A student nurse interviewing a client with paranoid schizophrenia leans forward and touches the client on the knee, stating, "I'm so sorry for everything you have been through."
The client jumps up, grabs the student's arm, and states, "You guys are all the same! You don't care about me!" During post-conference the nursing instructor tells the student nurse to: A) Inform the client that she needs to receive care and you will assist her.
B) Greet the client by gently touching her arm and telling her she can trust you.
C) Respect the client's need for personal space and avoid physical contact with the client.
D) Tell the client that if she does not comply with the rules, you will inform the doctor.
C
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A client has a blood pressure of 142/92 mmHg. Which medical terminology is appropriate for the nurse to use when documenting this data?
A) Normal. B) Hypertension Stage I. C) Prehypertension. D) Hypertension Stage II.
A 32-year-old patient receiving chemotherapy for breast cancer is prescribed aprepitant (Emend). What should the nurse emphasize when teaching the patient about this medication?
Select all that apply. 1. Take this medication for 10 days. 2. Take the medication either with food or on an empty stomach. 3. Use a barrier contraceptive while taking this medication. 4. A skin rash is an expected effect of this medication. 5. Contact the healthcare provider about any onset of confusion.
The patient requires vacuum extraction assistance. To provide easier access to the fetal head, the physician cuts a mediolateral episiotomy. After delivery, the patient asks the nurse to describe the episiotomy
The nurse responds, "The episiotomy: 1. "Goes straight back toward your rectum." 2. "Is from your vagina toward the urethra." 3. "Is cut diagonally away from your vagina." 4. "Extends from your vagina into your rectum."
The recovery nurse is caring for a surgical patient in the PACU. The patient's blood pressure is dropping and their heart rate is increasing. The nurse suspects the patient is:
A) overmedicated. B) experiencing normal adaptation to the postoperative period. C) allergic to the anesthesia. D) developing shock.