A home health nurse is conducting a home visit.

Exhibits

Click to highlight the findings that are risk factors for malnutrition in older adults. To deselect a finding, click on the finding again.

Nurses' Notes

Client is an older adult client with a history of osteoporosis, hypertension, and depression. Client is living independently with help of an aid for housekeeping and laundry. General appearance is neat, hair combed, clothing appropriate for weather. Skin color appropriate for ethnicity, overall skin is dry with bruising and small skin tear noted on knuckle of right hand. Dentures in glass on table. Client reports dentures don't fit well and make their mouth sore. Cough noted while client was drinking juice. Client reports appetite is decreased due to not being very hungry. Client reports eating mostly dinners that adult child prepares and freezes for them. Client states, "I just have to heat them up." Client also states. "Food just doesn't taste good anymore, and have a hard time chewing anything."

A nurse is caring for an 18-month-old toddler who has been hospitalized for 10 days. After the toddler's mother leaves the room, the nurse observes the toddler sitting quietly in the corner of the crib, sucking her thumb. When the nurse approaches the crib, the toddler turns away from the nurse. The nurse should understand that these behaviors indicate which of the following developmental reactions?

A nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and receiving IV fluid. The nurse observes variable decelerations in the fetal heart rate on the monitor strip. Which of the following is a correct interpretation of this finding?

A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1 min and a frequency of 3 min. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min and maternal blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse to take?

A nurse at a prenatal clinic is caring for a client who is in her first trimester of pregnancy. The client tells the nurse that she is upset because, although she and her husband planned this pregnancy, she has been having many doubts and second thoughts about the upcoming changes in her life. Which of the following is an appropriate response by the nurse?

A home health nurse is conducting a home visit.

Click to highlight the findings that are risk factors for malnutrition in older adults. To deselect a finding, click on the finding again.

Nurses' Notes

Client is an older adult client with a history of osteoporosis, hypertension, and depression. Client is living independently with help of an aid for housekeeping and laundry. General appearance is neat, hair combed, clothing appropriate for weather. Skin color appropriate for ethnicity, overall skin is dry with bruising and small skin tear noted on knuckle of right hand. Dentures in glass on table. Client reports dentures don't fit well and make their mouth sore. Cough noted while client was drinking juice. Client reports appetite is decreased due to not being very hungry. Client reports eating mostly dinners that adult child prepares and freezes for them. Client states, "I just have to heat them up." Client also states. "Food just doesn't taste good anymore, and have a hard time chewing anything."

A nurse is caring for several clients who are at various developmental stages. The nurse should explain that, according to Erikson, acceptance of death is a primary task of which of the following stages of psychosocial development?

A nurse is instructing a woman who is contemplating pregnancy about nutritional needs. To reduce the risk of giving birth to a newborn who has a neural tube defect, which of the following information should the nurse include in the teaching?

A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse observes early decelerations on the monitor strip and interprets them as indicating which of the following?

A nurse is developing an education program for a community group about dietary intake of vitamins and minerals in the diet. The nurse should include which of the following foods as sources of vitamin C?

A nurse is collecting data from a child who is descending stairs by placing both feet on each step and holding on to the railing. The nurse should understand that these actions are developmentally appropriate at which of the following ages?