You are attempting to examine the eyes of a newborn. To facilitate eye opening, you would first:
a. dim the room lights.
b. elicit pain.
c. place him in the supine position.
d. shine the penlight in his or her eyes.
A
The best way to assess the eyes of a newborn is to start by dimming the lights because it encou-rages infants to open their eyes.
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The client who should be assessed as demonstrating aggression is
a. A, who stomps away from the nurses' station, goes into the day room, and grabs a pool cue from a client standing at the pool table. b. B, who bursts into tears, leaves the community meeting, and sits on her bed hugging her pillow and sobbing. c. C, who tells her primary nurse "When you told me that I could not have a pass, I felt angry.". d. D, who tells the medication nurse "I am not going to take that, or any other, medication.".
Following mastectomy, many patients experience lymphedema. To minimize this problem, the nurse can instruct the patient to:
1. keep the arm elevated as much as possible. 2. take Lasix, 20 mg twice daily, as ordered. 3. use a sling during the day to rest the arm. 4. avoid exercising the arm for several weeks.
The nurse is caring for a patient with blood collecting in the pleural space. The nurse documents this as:
a. pleural effusion. b. hemothorax. c. pulmonary hemorrhage. d. pneumothorax.
A patient's spouse phones the clinic and reports, "My husband used his dorzolamide (Trusopt) eye drops, and his eyes and eyelids are very red. What should we do?" Select the nurse's best response
a. "This is a normal and transient reaction. Continue the drops as prescribed." b. "This is a common side effect and means that the drug is working." c. "You are using the drug too frequently. Skip every other dose for the next week." d. "Stop using the drops and bring him to the office as soon as possible."