Why it is important to check the neck for position and involutary movement. 2) what should the nurse consider when inspecting the buccal mucosa of a african american or indian decent. 3) what should the nurse do when the pupil are unequal in size? 4) what should the nurse do if the pain is too great to assess For tenderness?
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- 5) The nurse is assessing a toddler who is admitted with suspected intussusception and presents with vomiting, and blood and mucus present in the stools. Which action should the nurse implement first? A. Insert a nasogastric tube to low intermittent suction. B. Maintain NPO status and initiate IV fluid hydration. C. Use a faces pain scale to medicate for pain as prescribed. D. Prepared for radiographic studies to determine treatment options.An older client is having photocoagulation for macular degeneration. Which intervention should the nurse implement during the postprocedure care in the outpatient surgical unit? A. Arrange food on the plate in clockwise order B. Apply bilateral eye patches while sleeping C. Verbally identify self when entering the room D. Use a white board to communicate ideasThe nurse is discharging a patient home after surgery for trigeminal neuralgia. What advice should the nurse provide to this patient in order to reduce the risk of injury? Avoid rubbing the eye on the affected side of the face. Use over-the-counter antibiotic eye drops for at least 14 days. Avoid watching television or using a computer for more than 1 hour at a time. Rinse the eye on the affected side with normal saline daily for 1 week.
- The client who has had abdominal surgery is complaining of pain and tells the nurse, “I felt something pop in my stomach.” Which intervention should the nurse implement first? 1. Check the client’s apical pulse and blood pressure. 2.Determine the client’s pain on a 1 to 10 pain scale. 3. Assess the client’s surgical wound site. 4. Administer pain medication intravenously.A patient is admitted with a diagnosis of Guillain-Barre syndrome (GBS). Which of the following findings on physical examination would be MOST concerning for the nurse? a) Decreased muscle strength b) Absent deep tendon reflexes c) Sensory disturbances in the extremities d) Difficulty swallowingDuring a nurses assessment of a patient's abdominal pain, the nurse asks where the pain is located. Which part of the PQRST assessment is the nurse asking about? OT
- Which technique would be most appropriate to use when the nurse is teaching a patient with a language barrier?a )Obtain an interpreter who can speak in the patient’s native tongue for teaching sessions.b) Use detailed explanations, speaking slowly and clearly.c) Assume that the patient understands the information presented if the patient has no questions.d )Provide only written instructions.The medication nurse is to administer medications to a hospitalized client. Which of the following actions would a nurse be expected to perform when instilling eyedrops correctly? (Select all that apply.) 1. Wash hands and put on gloves. 2. Have the patient look up and focus on something on the ceiling. 3. Place the thumb near the margin of the lower eyelid and exert pressure upward over the bony prominence of the cheek. 4. Tilt the patient's head back slightly if sitting or place the head on a pillow if lying down. 5. Clean the eyelids and eyelashes of any drainage with cotton balls soaked in clean water.How should the nurse treat a patient of Italian descent in order to enhance the possibility of adherence to a medical regimen to improve the patient's condition?
- The nurse is practicing the therapeutic communication technique of broad opening. Which of thefollowing statements by the nurse best demonstrates a correct understanding of this technique?a. “How do you feel when you are arguing with your daughter?”b. “What are you thinking about?”c. “Are you planning on hurting yourself?”d. “You are biting your fingernails. Is something bothering you?”What activities will the nurse tell the client to avoid after cataract surgery? (Select all that apply.) Sleeping for greater than 1 hour Lifting items greater than 10 pounds Blowing one's nose Bearing down when one defecates UrinatingA child admitted to the neuro ward suddenly became unresponsive and started showing abnormal hand and leg movements with up rolling of eyeballs and tongue bite in front of the relative. Which of the following actions by the relative should be stopped by the nurse? Answer Choices: a. Turning the patient on one side b. Protecting the patient by keeping side rails up c. Inserting a rubber object between teeth to prevent tongue bite d. Loosening the clothes of the child