Exhibits

For each client statement, select the statement(s) below that require follow-up teaching by the nurse.

 "This diagnosis means that I am crazy." 

 "I can learn to manage my thoughts better through therapy." 

 "I can use holistic approaches like meditation to help my symptoms." 

 "Many people have the same response to a stressful situation as I am having right” 

 "I am at high risk for post-traumatic-stress disorder because I have acute stress disorder” 

 "I will probably need to be on medication for the rest of my life." 

The nurse is developing a plan of care for an older client with hypertension who reports chest pain on exertion. Which outcome should the nurse include in the plan of care for this client?

A client with benign prostatic hyperplasia (BPH) is preparing for discharge following a transurethral needle ablation (TUNA). Which information should the nurse include in the discharge instructions?

Patient Data

On further assessment, the client reports that her doctor A had recently started her on Lisinopril for blood pressure control but it "doesn't seem to help". She then complained of some chest discomfort. The client is moved to an ED room, and another set of vital signs is performed. Physician notified and orders received.

ECG monitor shows a slight peaked T-wave.

What treatments should the nurse anticipate for the client at this time? Select all that apply.

Patient Data

The client has been in IMU unit for 3 days and the physician plans to discharge her home today.

Select the client actions that were effective in her treatment.

Patient Data

The nurse is reviewing the history and physical.

Choose the most likely options for the information missing from the statement below by selecting from the list of options provided.

Based on the client's subjective and objectives data, the nurse recognizes that she is having signs and symptoms of a

A female client with bulimia is admitted to the mental health unit after she disclosed to a friend that she purges after meals. Which intervention should the nurse implement first?

The nurse is teaching a client with cancer about skincare for the portal site receiving external beam radiation. Which client action regarding skin care indicates a need for further teaching?

Click to highlight the assessment findings that require IMMEDIATE follow-up by the nurse.

The client is a 68-year-old with a history of diabetes, hypertension (HTN), coronary artery disease (CAD), and recently diagnosed with end-stage renal disease (ERSD). She has been on hemodialysis three times a week for one month and presents to the emergency department (ED) with:

• Fatigue
• Generalized weakness
• Muscle cramps
• Tingling sensation in her arms and legs
• Lightheadedness

She also reports having missed her scheduled dialysis for the past 2 days, coupled with complaints of nausea, poor appetite, and an inability to attend the dialysis sessions.

Initial Vital Signs:

• Blood Pressure: 146/82 mmHg
• Heart Rate: 114 bpm
• Respiratory Rate: 18 bpm
• SpO₂: 98% on room air
• Temperature: 98.2 °F (36.8 °C) orally

An adolescent client is admitted to the postoperative unit following open reduction of a fractured femur which occurred when the client fell down the stairs at a party. The nurse notices needle marks on the client's arms. Which assessment findings should the nurse document related to suspected narcotic withdrawal?

Patient Data

The nurse engages the client in conversation about her feelings and some of her coping mechanisms.

Click to specify which client statement or behavior is most likely associated with each of the listed defense mechanisms. Some statements or behaviors may be consistent with more than one mechanism. Each column must have at least one but may have more than one answer selected.