Autonomy vs. shame and doubt- 12-18 months old. Existential Question: Is It Okay to Be Me?
Weight loss would be expected.
Weight gain due to fluid accumulation is associated with heart failure and congenital heart defects.
Initiative vs. guilt- 3-6 years old. Existential Question: Is it Okay for Me to Do, Move, and Act?
In this case, you can determine the name of the child by the father’s statement. You should not withhold the medication from the child after identification.
The skin would be dry and not oily.
The bronchodilator will allow a more productive cough.
Cl. difficile has not been linked to meningitis.
Aspirin is not known to cause discoloration of the urine. Option A: Sulfasalazine may discolor the urine or skin to an orange-yellow color. Option B: Levodopa may discolor the urine, saliva, or sweat to a dark brown color. Option C: Phenolphthalein can discolor the urine to a red color.
Aspirin is not known to cause discoloration of the urine. Option A: Sulfasalazine may discolor the urine or skin to an orange-yellow color. Option B: Levodopa may discolor the urine, saliva, or sweat to a dark brown color. Option C: Phenolphthalein can discolor the urine to a red color.
Examine the child’s scalp and hair for evidence of small, white, sesame seed size flecks which cannot be brushed away or pulled off of the hair. This is the most appropriate response because you will not be able to provide accurate information to the physician if you do not examine the child’s scalp and hair for evidence of head lice (pediculosis). The child could just have an irritated scalp or dandruff. It is not appropriate to make an assumption or judgment about the patient due to the only symptom reported which is pruritus of the scalp.
A multiparous C-section patient who is two days post-op should be stable and mobilizing fairly well. Since she is a repeat C-section and multiparous, she has experienced a C-section and most likely is quite comfortable breastfeeding her new infant. Out of all the patient choices, she is the most stable. The primiparous four hour post vaginal delivery patient is still in need of immediate postpartum teaching and will be at a higher risk for complications than some of the other more stable patients. Even though the multiparous C-section patient is stable enough to be discharged, she will require discharge teaching and instructions. The primiparous patient who would like to discuss tubal ligation should be assessed for signs of post-partum depression and she may require counseling and follow up by her treating physician.
The 70 year old woman who is only one day post-op from ankle surgery has probably been immobile due to her age and the surgery type and is at a greater risk of thrombophlebitis and the subsequent complication of pulmonary embolus. If she is complaining of shortness of breath, her vital signs should be obtained and the physician should be notified. This patient is the highest priority, though all have the potential to have some type of medical complication.
People who are of the Muslim religion or Islamic faith prohibit pork in their diet. In some sects of Buddhism, Seventh-Day Adventism they are vegetarian. Jewish people adhere to the kosher laws if they are Orthodox believers. People who practice Hinduism are prohibited from eating beef and veal. Spicy foods are normally not a dietary restriction of a particular religion.
Asian Americans value silence. Eye contact may be considered inappropriate or disrespectful. It is important for the nurse to be aware of these cultural differences so that he/she does not assume that this is unusual behavior. It would be inappropriate of the nurse to continue talking to the patient to try to “engage” them in conversation. The nurse should not assume that the patient is exhibiting signs of depression or physical instability due to the understanding of this as normal behavior within this culture.
t is important for the nurse to understand that in the African American, head nodding does not necessarily mean agreement or acceptance or understanding of information presented. The other statements are untrue.
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NCLEX-RN Test #12
