What will the nurse keep in mind when documenting the suspected abuse of an older patient?
1. Photo documentation is not usually included as part of the documentation.
2. Documentation should include objective data of the older patient's reaction when the suspected abuser is present.
3. It is important to include the nurse's personal opinion of the suspected abuser and the nurse's prior experience in similar cases.
4. The details of the documentation should not be reported to the adult protective services; it is important that they come to an independent conclusion about the issue of abuse.
2
Rationale: Photographic documentation is especially helpful in cases where there is observable evidence.
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An adolescent is in the family practice clinic to obtain birth control. She began menstruating 4 days ago and wants the Depo-Provera injection because of the convenience associated with the method
What action by the nurse is best? A. Administer the injection as prescribed. B. Assist the teen in choosing another method. C. Document that education was completed. D. Obtain a urine sample for a pregnancy test.
A client with heart failure is given discharge instructions by the nurse. As the client leaves the hospital, the nurse recognizes that, statistically, this client has a _______ likelihood of readmission within 6 months
1. 30% to 50% 2. 50% to 75% 3. 0% to 20% 4. 20% to 30%
The nurse may wish to place an eye patch on the affected eye after instillation of eye ointment to:
a. follow standard nursing practice. b. protect the eye from photosensitivity caused by ointments. c. control drainage from the eye. d. protect the eye because ointments remove the protective blink reflex.
After completing instructions for collecting a sputum specimen to the client, the nurse observes the client remove the lid of the specimen container and spit into the cup. Which is the nurse's next best action?
A. Ask the client if the specimen obtained was sputum or saliva. B. Explain to the client that the specimen will have to be obtained by suctioning. C. Provide the client with a new specimen container and explain again how to obtain the specimen. D. Send the specimen to the lab as obtained but label it as saliva.