While discussing home safety with the nurse, a patient admits that she always smokes a cigarette in bed before falling asleep at night. Which nursing diagnosis would be the priority for this patient? a. Impaired Gas Exchange related to cigarette smoking b. Anxiety related to inability to stop smoking c. Risk for Suffocation related to unfamiliarity with fire prevention guidelines d. Deficient Knowledge related to lack of follow-through of recommendation to stop smoking

While discussing home safety with the nurse, a patient admits that she always smokes a cigarette in bed before falling asleep at night. Which nursing diagnosis would be the priority for this patient? a. Impaired Gas Exchange related to cigarette smoking b. Anxiety related to inability to stop smoking c. Risk for Suffocation related to unfamiliarity with fire prevention guidelines d. Deficient Knowledge related to lack of follow-through of recommendation to stop smoking

Comprehensive Medical Assisting: Administrative and Clinical Competencies (MindTap Course List)

6th Edition

ISBN:9781305964792

Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa

Publisher:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa

Chapter24: The Physical Examination

Section: Chapter Questions

Problem 4CR

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While discussing home safety with the nurse, a patient admitsthat she always smokes a cigarette in bed before falling asleepat night. Which nursing diagnosis would be the priority forthis patient?a. Impaired Gas Exchange related to cigarette smokingb. Anxiety related to inability to stop smokingc. Risk for Suffocation related to unfamiliarity with fireprevention guidelinesd. Deficient Knowledge related to lack of follow-through ofrecommendation to stop smoking
Which action would be most important for a nurse to includein the plan of care for a patient who is 85 years old and haspresbycusis?a. Obtaining large-print written materialb. Speaking distinctly, using lower frequenciesc. Decreasing tactile stimulationd. Initiating a safety program to prevent falls
The nurse is assessing the respirations ola client with chronic obstructivepulmonary disease (COPD). What is therationale for the nurse to assess therespiratory rate without the client beingaware of it? It is more efficient for the nurse todo so because it takes less time Client awareness might alter therespiratory rate or pattern The client might suppressKussmaul's respirations if awarethe respirations are being counted It allows for observation forrespiratory distress, tachypnea, ororthopnea
A nurse is assessing the vital signs of patients who presentedat the emergency department. Based on the knowledge ofage-related variations in normal vital signs, which patientswould the nurse document as having a normal vital sign?Select all that apply.a. A 4-month old infant whose temperature is 38.1°C(100.5°F)b. A 3-year old whose blood pressure is 118/80c. A 9-year old whose temperature is 39°C (102.2°F)d. An adolescent whose pulse rate is 70 bpme. An adult whose respiratory rate is 20 bpmf. A 72-year old whose pulse rate is 42 bpm
A nurse is inserting a nasogastric tube ordered for a patientto monitor bleeding in his GI tract. When the tube is beingpassed through the pharynx, the patient begins to cough andshow signs of respiratory distress. What would be the priorityaction of the nurse upon this assessment?a. Keep the tube in place and notify the primary care providerimmediately.b. Stop advancing the tube and pull it back into the nasalarea.c. Ask the patient if he wants the nurse to stop the procedure.d. Call for help to perform CPR.
A nurse is responsible for preparing patients for surgery in anambulatory care center. Which technique for reducing anxietywould be appropriate for these patients?a. Discouraging over-verbalization of fears and anxietiesb. Focusing on the outcome as opposed to the details of thesurgeryc. Providing time alone for reflection on personal strengthsand weaknessesd. Mutually determining expected outcomes of the planof care
Mr. Wright is recovering from abdominal surgery. When thenurse assists him to walk, she observes that he grimaces, moves stiffly, and becomes pale. She is aware that he hasconsistently refused his pain medication. What would be apriority nursing diagnosis for this patient? a. Acute Pain related to fear of taking prescribed post-operative medications b. Impaired Physical Mobility related to surgical procedurec. Anxiety related to outcome of surgeryd. Risk for Infection related to surgical incision
A nurse is developing a plan of care related to preventionof pressure ulcers for residents in a long-term care facility.Which action would be a priority in preventing a patient fromdeveloping a pressure ulcer?a. Keeping the head of the bed elevated as often as possibleb. Massaging over bony prominencesc. Repositioning bed-bound patients every 4 hoursd. Using a mild cleansing agent when cleansing the skin
A visiting nurse is performing a family assessment of ayoung couple caring for their newborn who was diagnosedwith cerebral palsy. The nurse notes that the mother’s hairand clothing are unkempt, the house is untidy, and themother states that she is “so busy with the baby that I don’thave time to do anything else.” What would be the priorityintervention for this family?a. Arrange to have the infant removed from the home.b. Inform other members of the family of the situation. c. Increase the number of visits by the visiting nurse.d. Notify the care provider and recommend respite care forthe mother.
Which statement is a complete nursing diagnosis statement? Ineffective airway clearance related to mucus plugs and nonproductive cough O a. O b. Tachycardią c. Shortness of breath related to anxiety С. O d. Hyperventilation related to anxiety
What is the priority assessment for the nurse to evaluate the effectiveness of the furosemide for this patient? A. Assess breath sounds B. provide incentive spirometer C. begin CPR D. raise the head of the bed E. apply oxygen
A nurse is providing postural drainage for a patient withcystic fibrosis. In which position should the nurse place thepatient to drain the right lobe of the lung?a. High Fowler’s positionb. Left side with pillow under chest wallc. Lying position/half on abdomen and half on sided. Trendelenberg position