When determining the presence of stage 1 hypertension, the nurse finds repeated measurements of:
A. 130/85 mm Hg
B. 140/90 mm Hg
C. 160/100 mm Hg
D. 200/110 mm Hg
B
B. Stage 1: systolic 140-159, diastolic 90-99
C and D. Stage 2: systolic > 160, diastolic > 100
A. Prehypertension: systolic 120-139, diastolic 80-89
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The nurse is caring for a trauma patient with the nursing diagnosis of Acute pain r/t fracture and muscle spasms. Which is an appropriate goal for this nursing diagnosis?
a. The patient will experience less pain when participating in physical therapy. b. The patient will describe meditation techniques that can be used to cope with pain. c. Nursing staff will explain the ordered pain management approach to the patient. d. The patient will feel less pain each day when range-of-motion therapy is performed.
Which client is most at risk for a low-birth-weight infant?
a. 22-year-old, 60 inches tall, normal prepregnant weight b. 18-year-old, 64 inches tall, body mass index is <18.5 c. 30-year-old, 78 inches tall, prepregnant weight is 15 lb above the norm d. 35-year-old, 75 inches tall, total weight gain in previous pregnancies was 33 lb
Why should continuous enteral nutrition formulas be administered within 4 hours?
a. When given over a period longer than 4 hours the patient's nutrition will be inadequate. b. The water soluble vitamins contained in enteral formulas quickly degrade outside of the body. c. The risk for overgrowth of infectious microorganisms in the enteral formula increases after 4 hours. d. The risk for clogging the feeding tube increases when enteral formulas are administered more slowly.
A parent of a 14-year-old female asks the nurse about the HPV vaccine. Which information should the nurse include in the teaching?
A. "Your daughter will need to be vaccinated when she becomes sexually active." B. "Your daughter will need one dose of the vaccine." C. "Your daughter will need three doses of the vaccine." D. "Your daughter will need two doses of the vaccine."