The nurse is working on a telemetry unit at a local hospital. The nurse obtains report on a client with symptoms of sharp chest pain and tachycardia. The nurse begins to collect and critical think through assessment data
Which client symptom distinguishes between a myocardial infarction and myocarditis? A) Pulse deficit
B) White frothy sputum
C) +3 Peripheral edema
D) Relief of pain when sitting up
D
Feedback:
Clients may complain of sharp, stabbing discomfort that resembles a myocardial infarction; however, sitting up relieves the pain. There is no correlation between white frothy sputum, peripheral edema, or a pulse deficit and the disease processes.
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The client verbalizes concern for hospitalization because he doesn't believe there are any health issues. The nurse explains to the client that health is:
a. a state of optimal wellness where the individual moves toward integration of human functioning b. a state of complete physical, mental, and social well-being c. promotion of wellness, including disease prevention d. the absence of illness or disease
The nurse is caring for four clients on the medical-surgical unit of the hospital. What client is mostly likely to be receiving treatment for sickle cell crisis?
A) A 29-year-old Caucasian female B) A 19-year-old African American male C) A 24-year-old Native American female D) A 36-year-old Eastern European female
A postpartum mother questions whether the environmental temperature should be warmer in the baby's room at home. The nurse responds that the environmental temperature should be warmer for the newborn
This response by the nurse is based on which of the following newborn characteristics that affect the establishment of a neutral thermal environmental? Select all that apply. 1. Newborns have a decrease in subcutaneous fat. 2. Newborns have a thick epidermis layer. 3. Flexed posture of the term newborn 4. Blood vessels are closer to the skin. 5. Newborns have an increase in subcutaneous fat. Correct
The patient is admitted with exposure to an unknown chemical. His clothing appears to be grossly contaminated. What should the nurse do? (Select all that apply.)
a. Avoid touching contaminated parts of clothing. b. Pull the patient's tee shirt off over his head. c. Cut the patient's clothes off. d. Wash the patient with large amounts of soap and water.