A client arrives at the emergency department with chest pain after taking sildenafil.
Based on the client's history, which medication should the nurse withhold?

The nurse observes an 18-month-old toddler keeping a bottle of milk in the mouth throughout the history-taking and assessment process during a well-child visit.

The mother confirms that the child has a bottle available most of the day and remarks that it makes a great pacifier.

Which response should the nurse provide?

A client with bleeding esophageal varices receives vasopressin intravenously (IV). Which adverse effect should the nurse monitor for during the IV infusion of this medication?

Patient Data.

What are three goals of therapy for this client? Select three that apply.

A client is admitted to the intensive care unit with diabetes insipidus due to a pituitary gland tumor.

Which potential complication should the nurse monitor closely?

The nurse observes a client with amyotrophic lateral sclerosis (ALS) is excessively drooling and prepares to suction the client's oral cavity.
Which action should the nurse include?

The nurse on the medical-surgical unit is receiving a transfer report from the post-anesthesia care unit (PACU) nurse for a client who had an exploratory laparotomy.

The PACU nurse provides the following information: "1000 mL normal saline is infusing at 125 mL/hr into the left wrist with 600 mL remaining.

Ondansetron 4 mg intravenously every 8 hours is prescribed for nausea.

The last dose was administered at 0700.

The client is currently describing pain at a level 2 on a 0 to 10 pain scale.

The client has a prescription for hydromorphone 1 mg intravenously every 2 hours as needed for pain.

The last dose was administered at 1000." Which additional information should the PACU nurse report?

A female client who is admitted to the mental health unit for opiate dependency is receiving clonidine 0.1 mg by mouth (PO) for withdrawal symptoms.

The client begins to complain of feeling nervous and tells the nurse that her bones are itching.

Which finding should the nurse identify as a contraindication for administering the medication?

The nurse is caring for a client who reports sudden right-sided numbness and weakness of the arm and leg.

The nurse also observes a distinct right-sided facial droop.

After reporting the findings to the healthcare provider, the nurse receives several prescriptions for the client, including a STAT Computerized tomography scan of the head.

Which action should the nurse take first?

When performing a focused gastrointestinal system assessment, the practical nurse (PN) asks a male client when his last bowel movement occurred. The client answers, "Three days ago." Which action should the PN implement first?

The nurse is planning care for a client who has a fourth-degree midline laceration that occurred during vaginal delivery of an 8-pound 10-ounce (3674 grams) infant.

Which intervention has the highest priority for this client?