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The Nursing Process -WITH CORRECT ANSWERS

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A client with chronic renal failure is admitted with a heart rate of 122 beats/minute, a respiratory rate of 32 breaths/minute, a blood pressure of 190/110 mm Hg, jugular vein distention, and bibasilar crackles. Which nursing diagnosis takes highest priority for this client? - CORRECT ANSWERS-exces...

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  • October 28, 2024
  • 26
  • 2024/2025
  • Exam (elaborations)
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The Nursing
Process
-WITH CORRECT
ANSWERS

,After the surgeon's meeting with a client to obtain the client's informed consent for a
modified radical mastectomy, the client asks the nurse many questions about breast
reconstruction that the nurse finds difficult to answer. The nurse should: - CORRECT
ANSWERS-Inform the surgeon that the client has questions about reconstruction before
she signs the consent.


A client with chronic renal failure is admitted with a heart rate of 122 beats/minute, a
respiratory rate of 32 breaths/minute, a blood pressure of 190/110 mm Hg, jugular vein
distention, and bibasilar crackles. Which nursing diagnosis takes highest priority for this
client? - CORRECT ANSWERS-excess fluid volume


A client has received numerous different antibiotics and now is experiencing diarrhea.
What type of precautions should the nurse institute? - CORRECT ANSWERS-contact
precautions


A client's diagnosis of pneumonia requires treatment with antibiotics. The corresponding
order in the client's chart should be written as - CORRECT ANSWERS-moxifloxacin 400
mg daily


A home care nurse is caring for a paralyzed client who needs regular position changes
and back massages. A person identifying themself as a family friend inquires if they can
be of any help to the family. What should be the nurse's response be? - CORRECT
ANSWERS-The nurse should ask the person to talk to the family directly.


A nurse who works on a palliative care unit has participated in several clinical scenarios
that have required the application of ethics. Ethics is best defined as - CORRECT
ANSWERS-the principles that determine whether an act is right or wrong

, A mentally incapacitated client is scheduled for surgery. Considering the principle of
autonomy, who should give the consent for surgery? - CORRECT ANSWERS-surrogate
decision maker


In preparation for discharge, the nurse is reviewing information related to new dietary
guidelines with the client. This is an example of which step in discharge planning? -
CORRECT ANSWERS-providing client teaching


A client in a long-term care facility signed a form requesting not to be resuscitated. The
client develops pneumonia, and the client's health rapidly deteriorates. The client is no
longer competent, but the family wants everything possible done for the client. When
the family asks the nurse what will be done, what is the best response by the nurse? -
CORRECT ANSWERS-"We will continue to use antibiotics to treat the pneumonia."


A public health nurse is responsible for contact tracing of individuals identified in
confirmed cases of sexually transmitted infections. The nurse telephones an individual
named by a client as a contact. The individual demands the name of the person who
identified the individual as a contact. Which of the following is the most appropriate
response from the nurse? - CORRECT ANSWERS-"Just as I will protect your privacy, I
must protect the privacy of the other people involved."


A nurse is caring for a client who speaks only French. The client's grandchild is bilingual
and assists with translating, but the nurse needs to provide the client with discharge
instructions. Which of the following would be the best option for the nurse and the
client? - CORRECT ANSWERS-Ask the manager to find an interpreter who is able to
provide the discharge instructions.


A nurse suspects that a coworker is self-administering illegal drugs during work hours.
What is the first action the nurse should take? - CORRECT ANSWERS-Notify the nurse
manager and document the situation.

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