A 78-year-old woman is admitted to the hospital with a diagnosis of pneumonia. She appears to be confused and combative at times. Her daughter is concerned because her mother was alert and oriented prior to being diagnosed with pneumonia
Her altered mental status is related to: a. The onset of Alzheimer's disease
b. Alteration in oxygenation
c. Result of family neglect
d. Dysfunctional coping
B
Physical problems can lead to changes in mental status. Early assessment and intervention are key for keeping older adult's minor problems from becoming major ones. An alteration of the patient's oxygenation can affect a client's behavior.
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The client has a strong belief that he can successfully change his eating and exercise pattern in order to lose weight. Using Pender's Health-Promotion Model, how would the nurse document this belief?
1. As a positive activity-related affect. 2. As a perceived barrier to action. 3. As positive self-efficacy. 4. As good interpersonal influence.
Which assessment parameter does the nurse monitor in a client with chronic kidney disease to determine fluid and sodium retention status?
a. Capillary refill b. Intake and output c. Muscle strength d. Weight and blood pressure
A patient in a detoxification unit asks, "What good it will do to go to Alcoholics Anonymous and talk to other people with the same problem?" The nurse's best response would be to explain that self-help groups such as AA provide opportunities for:
a. newly discharged alcoholics to learn about the disease of alcoholism. b. people with common problems to share their experiences with alcoholism and recovery. c. patients with alcoholism to receive insight-oriented treatment about the etiology of their disease. d. professional counselors to provide guidance to individuals recovering from alcoholism.
A patient who had a motor vehicle accident 2 days ago is experiencing pain and is receiving patient-controlled analgesia (PCA). How does the nurse know that the patient is experiencing effective pain management with the PCA?
a. The patient is sleeping and is difficult to arouse. b. The patient rates pain at an acceptable level of 3 on a 0 to 10 scale. c. Sufficient medication is left in the PCA syringe. d. The patient presses the control button to deliver pain medication.