The nurse anticipates that the client with a fluid volume excess will manifest which one of the following signs?
a. Increased urine specific gravity
b. Decreased body weight
c. Increased blood pressure
d. Decreased pulse strength
C
Hypertension is manifested with fluid volume excess.
The urine specific gravity would be decreased with fluid volume excess. The nurse would antic-ipate an increased urine specific gravity with fluid volume deficit.
The nurse would anticipate an increase, not a decrease, in body weight with fluid volume excess.
The nurse would anticipate an increase, not a decrease, in pulse strength with fluid volume ex-cess.
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A nurse is assessing a healthy, older adult patient for an exercise program to be offered at the local hospital. During the evaluation, the nurse notes the following vital signs:
P = 72, RR = 16, BP = 132/70 . After 3 minutes of moderate-intensity running on the treadmill, the patient becomes short of breath and states, "I have to stop. I can't do this anymore." The nurse measures his vital signs again: P = 152, RR = 40, BP = 172/98 . She instructs him to rest. Vital signs return to baseline after 15 minutes. The nurse should recognize his symptoms as associated with which of the following? a. Anxiety b. Orthostatic hypotension c. Limited activity tolerance d. Respiratory distress
The nurse is preparing to admit a client with acute pneumonia who is experiencing severe respiratory acidosis. Which treatments does the nurse anticipate as appropriate for this client?
Select all that apply. A) Administer oxygen prn. B) Administer digoxin for heart failure. C) Encourage up to 3L of fluids per day. D) Place in a prone position. E) Reposition frequently.
The client is admitted to the acute care facility through the emergency department after presenting with complaints of an elevated temperature, elevated white blood cell count, nausea, and pain and tenderness in the lower right lower quadrant of the
abdomen. Analgesics were administered upon arrival to the emergency department and are not due for administration for at least another two hours. What response by the nurse is most correct? 1. "I will need to review your assessment with the physician first.". 2. "Let's try a heating pad or warm blanket.". 3. "I do not have any medications ordered for you at this time.". 4. "Why don't you try to rest for a while longer until it is time?"
A teenage patient tells the nurse that she is being abused by her boyfriend but she doesn't want her parents to know because they won't let her see him any longer. What is the best response by the nurse?
A) "It's my responsibility to tell your parents if you are in danger." B) "I understand your fear, but I am obligated to be sure your parents know you are in danger. Would you like for us to talk to them together?" C) "I won't tell them this time, but I must inform you that legally I must inform your parents if abuse is occurring. Next time it happens I will have to tell them." D) "You need to tell them because the abuse isn't going to get any better. It will only escalate no matter what your boyfriend says."