An adult patient who is hospitalized following a motorcycle accident when a car ran a red light tells the nurse, "I didn't sleep last night because I worried about missing work at my new job and losing my insurance coverage."
Which nursing diagnosis is appropriate to include in the plan of care?
a. Anxiety
b. Defensive coping
c. Ineffective denial
d. Risk prone health behavior
ANS: A
The information about the patient indicates that anxiety is an appropriate nursing diagnosis. The patient data do not support defensive coping, ineffective denial, or risk prone health behavior as problems for this patient.
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An 80-year-old woman who resides in a care facility is receiving treatment with oral fluconazole for a fungal infection. Following yesterday's and today's dose, she has complained of an upset stomach after taking the drug
How should the nurse at the facility best respond to the woman's complaint? A) Provide food along with the fluconazole when administering it in the future. B) Stop administering the fluconazole and inform the woman's physician. C) Arrange for the woman to receive intravenous fluconazole on an outpatient basis. D) Assess the woman for signs and symptoms of an infusion reaction.
The informatics nurse is reviewing the training plan on downtown procedures. Which information should be an integral part of this plan?
A) Length of time to expect the system to be down B) When to enter data back into the computer system C) Location to store the patient information until the system is available D) Identify the person responsible for protecting the personal health information
The nurse is caring for a client who had ileostomy surgery 10 days ago. The client verbalizes concerns that the effluent has not become formed and is still liquid green. Which is the nurse's best response?
a. "I will call your health care provider right away because the stool should be semi-solid by now." b. "Your stools will firm up in a few weeks as your body gets used to the ileostomy." c. "You should eat a high-fiber diet to help make the stool bulkier and more solid." d. "You can add buttermilk or yogurt to your diet and avoid carbonated soft drinks."
The family of a dying patient wants to help relieve the patient's progressive dyspnea. What should the nurse instruct the family to do for the patient?
A. Raise the head of the bed. B. Perform chest physiotherapy. C. Suction the patient as much as possible. D. Lower the head of the bed.