ollowingdischargeteaching,amaleclientwithduodenalulcertellsthenursethehewilldrinkplentyof
dairyproducts,suchasmilk,tohelpcoatandprotecthisulcer.Whatistheb
... [Show More]estfollow-upactionbythe
nurse?
•Reviewwiththeclienttheneedtoavoidfoodsthatarerichinmilkandcream
2.
Amaleclientwithhypertension,whoreceivednewantihypertensiveprescriptionsat
hislastvisitreturnstotheclinictwoweekslatertoevaluatehisbloodpressure(BP).
HisBPis158/106andheadmitsthathehasnotbeentakingtheprescribed
medicationbecausethedrugsmakehim―feelbad‖.Inexplainingtheneedfor
hypertensioncontrol,thenurseshouldstressthatanelevatedBPplacestheclientat
riskforwhichpathophysiologicalcondition?
•Strokesecondarytohemorrhage
3.
Thenurseobservesanunlicensedassistivepersonnel(UAP)positioninganewly
admittedclientwhohasaseizuredisorder.TheclientissupineandtheUAPis
placingsoftpillowsalongthesiderails.Whatactionshouldthenurseimplement?
•InstructtheUAPtoobtainsoftblanketstosecuretothesiderailsinsteadof
pillows.
4.
Anadolescentwithmajordepressivedisorderhasbeentakingduloxetine(Cymbalta)
forthepast12days.Whichassessmentfindingrequiresimmediatefollow-up?
•Describeslifewithoutpurpose
5.
A60-year-oldfemaleclientwithapositivefamilyhistoryofovariancancerhas
developedanabdominalmassandisbeingevaluatedforpossibleovariancancer.
HerPapanicolau(Pap)smearresultsarenegative.Whatinformationshouldthenurse
includeintheclient’steachingplan?
•Furtherevaluationinvolvingsurgerymaybeneeded
6.
Aclientwhorecentlyunderwearatracheostomyisbeingpreparedfordischargeto
home.
Whichinstructionsismostimportantforthenursetoincludeinthedischargeplan?
•Teachtrachealsuctioningtechniques
7.
Inassessinganadultclientwithapartialrebreathermask,thenursenotesthatthe
oxygenreservoirbagdoesnotdeflatecompletelyduringinspirationandtheclient’s
respiratoryrateis14breaths/minute.Whatactionshouldthenurseimplement?
•
Documenttheassessmentdata
Rational:reservoirbagshouldnotdeflatecompletelyduringinspirationandthe
client’srespiratoryrateiswithinnormallimits.
8.
Duringshiftreport,thecentralelectrocardiogram(EKG)monitoringsystemalarms.
Whichclientalarmshouldthenurseinvestigatefirs?
•Respiratoryapneaof30seconds
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