The nurse understands the following about informing and obtaining consent for an 8-year-old patient who is undergoing a heart transplant:
•Any child who is in the concrete operations stage of development must give assent, not consent. (This is usually any child over 7 years of age)
•Assent means having knowledge of the surgery and agreement with the parent or other person giving consent. The child does not need to sign anything.
The nurse on a labor and delivery unit is caring for a patient admitted for induction of labor. The doctor has written an order as follows: "Start oxytocin 4cc/hr IV." The doctor's handwriting is small and difficult to read. The nurse initiates the infusion at a rate of 400 milliliters per hour. After 10 minutes, the patient is in severe pain and the fetus is in distress. Of the following, which is true regarding this adverse event?
A patient receiving total parenteral nutrition is to be discharged to home care. The nurse recognizes that preventing complications such as infection and metabolic imbalances are major concerns that must be included in the discharge plan. When conducting the discharge teaching, which of the following will the
A nurse is transcribing physician orders for a patient who was admitted overnight. The nurse reads the following order: "16 u insulin glargine to be given by
The nurse develops strategies to resolve the patient's problems during which step of the nursing process?
A nurse witnesses another nurse slap a patient. The patient has been very difficult to manage and often very rude, observed screaming obscenities at other patients and staff. What action should the nurse take after witnessing this?
A nurse is documenting in the patient's chart and accidently transcribes an order incorrectly. After realizing her mistake, how should the nurse correct the error?
The nurse is administering hydromorphone, 1 mg PO, to a patient with moderate abdominal pain. The nurse can expect the patient's pain to improve after:
The nurse is caring for a patient with a chest tube. During her rounds, the nurse considers that the chest tube is working properly if she observes:
A patient is developing hives after the administration of blood products. The physician has ordered a one time dose of diphenhydramine. Which of the following side effects can the nurse expect?
A 16-month-old girl with Down syndrome has several cardiac defects that are inoperable. The parents are struggling to decide the next step. A care conference is held consisting of the family, the physician, the social worker, and the chaplain. Why should the nurse be involved in this discussion?
After a radioactive explosion, a group of nurses must use reverse triage to identify which patients should be decontaminated first and which others wait for treatment. Of the following, which is the correct order in which to process the victims of this event?
The nurse is preparing to administer one unit of packed red blood cells. The nurse should include which of the following interventions?
A patient suffering from respiratory failure requires mechanical ventilation. The physician has ordered the patient to be restrained. Which type of restraint is most appropriate in this situation?
A 22-year-old male patient who has been increasingly paranoid and intrusive with peers begins throwing furniture around and threatens to kill anyone who comes near him. Even after being safely secluded in an isolation room, he continues yelling and begins banging his head against the door with force. The psychiatrist on call orders 2mg lorazepam and 10 mg haloperidol IM x1 time STAT. What is the appropriate nursing action?