You are the circulating nurse in an operating room that has several surgeries scheduled. You would know to monitor which patient during the intraoperative period because he or she is at increased risk for hypothermia?
A) A 72-year-old woman
B) A 17-year-old boy
C) A 45-year-old woman
D) A 12-year-old girl
Ans: A
Feedback: Elderly patients are at greatest risk during surgical procedures because they have an impaired ability to increase their metabolic rate and impaired thermoregulatory mechanisms, which increase susceptibility to hypothermia. This makes options B, C, and D incorrect.
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The nurse recognizes that an ongoing assessment will help set priorities in the nursing care plan of a long-term care resident. Timely assessments allow the planning process to be:
a. based on the patient's disease process. b. patient-centered. c. preferential. d. categorized.
An 80-year-old woman who lives alone has begun calling friends and complaining in an exaggerated
fashion about minor aches and pains. Her physician found no significant medical problems. Over the course of a month, she obtained a number of prescriptions for pain medication, none of which seemed to be effective. Friends counseled her that aches are a normal part of life for the elderly and tried unsuccessfully to involve her in activities. She often suggested that she would be better off dead, to which one friend responded "Well, perhaps. It would get you out of your misery.". As she became increasingly "needy" and demanding of attention, friends agreed that her behavior made them uncomfortable and began to call and visit less. The woman took four pain pills and called a neighbor, saying she had overdosed. After medical clearance, the client will be monitored at the mental health clinic. Nursing interventions that have been agreed on for the client include hope instillation, coping enhancement, and support system enhancement. Measures designed to enhance the client's support system include (more than one answer may be correct) A. providing services in a caring manner. B. providing a referral to a self-help group. C. teaching cognitive restructuring. D. encouraging relationships with friends. E. identifying areas of hope in life. F. arranging situations that foster autonomy.
The nurse assists the client in a health promotion activity that also reduces the cost of health care delivery when:
1. Administering medication 2. Treating a diabetic foot ulcer 3. Obtaining an operative consent 4. Discussing exercise and nutrition
Evaluation of an appropriate use of a metered-dose inhaler by a client is evident when the client:
A. Does not shake the canister B. Presses the canister before taking a breath C. Holds the breath for 10 seconds after inhalation D. Takes another puff of medication quickly after the first dose