A male client with cirrhosis is experiencing symptoms of peripheral neuropathy. Which nursing intervention has the highest priority?
A. Teach the client to protect his feet from injury
B. Assess the client's intake of Vitamin B-rich foods
C. Observe the client's skin for signs for jaundice
D. Refer the client for alcohol abuse counseling
Ans: A. Teach the client to protect his feet from injury
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When caring for patients with chronic illness, the nurse needs to:
a. help the patient face the reality that he will not get better. b. emphasize to the patient that the illness is not his fault. c. emphasize improving quality of life through preventive behaviors. d. acknowledge the limitations placed on the patient by his suffering.
The nurse is caring for a postoperative client on the medical-surgical unit following a total left hip replacement the previous day. During the assessment, the nurse notes that the client's left leg is cool, with weak pedal pulses
What is the nurse's first action? a. Assess circulatory status of the right leg. b. Notify the surgeon immediately. c. Measure leg circumference at the calf. d. Check for bilateral Homans' signs.
The following patients are seen in the emergency department. The psychiatric unit has one bed available. Which patient should the admitting officer recommend for admission to the hospital? The patient who:
a. experiencing dry mouth and tremor related to side effects of haloperidol (Haldol). b. experiencing anxiety and a sad mood after a separation from a spouse of 10 years. c. who self-inflicted a superficial cut on the forearm after a family argument. d. who is a single parent and hears voices saying, "Smother your infant."
A community health nurse visits a family with four children. The father behaves angrily, finds fault with a child, and asks twice, "Why are you such a stupid kid?" The wife says, "I have difficulty disciplining the children. It's so frustrating."
Which comments by the nurse will facilitate the interview with these parents? Select all that apply. a. "Tell me how you punish your children." b. "How do you stop your baby from crying?" c. "Caring for four small children must be difficult." d. "Do you or your husband ever beat the children?" e. "Calling children ‘stupid' injures their self-esteem."