In preparing the patient for a paracentesis, the nurse must be sure
a. the patient is NPO for 12 hours before the procedure.
b. the patient is lying flat in bed for the procedure.
c. the fluid is removed over at least 30 minutes.
d. oral liquids and a light meal are given the evening after the procedure.
Question 2The nurse assesses a client with Parkinson's disease. Which of the following symptoms are unexpected, requiring immediate follow-up?
A) Drooling
B) Hallucinations
C) Hypoglycemia
D) Tremors
Question 3An 81-year-old female client has presented to the emergency department accompanied by her daughter with whom she lives. The daughter states that her mother has experienced a recent series of falls, which have resulted in her facial and arm bruises.
The client smells of urine and is noticeably emaciated, unkempt, and is anxious while the daughter berates her during the nurse's assessment. What is the nurse's responsibility in this situation? A) Determine the daughter's legal status with regard to her mother's financial affairs.
B) Report suspected elder abuse to the Adult Protective Services Department.
C) Establish whether the client has a durable power of attorney in place.
D) Obtain medical records regarding prior admissions for similar problems.
Question 4Nurse R works on the geriatric medicine unit of the university hospital and provides care for numerous older adult clients nearing the end of life, many of whom have Do Not Resuscitate (DNR) orders.
Which of the following situations is incompatible with the legal requirements for a DNR order? A) A client who is mentally competent has declared his wish to have a DNR order despite the availability of treatment options for his condition.
B) A client has expressed her desire to have a DNR order but her daughter is adamantly opposed to it.
C) A client clearly told the nurse her desire to have a DNR order, which the nurse documented and noted at the bedside.
D) A client has been in a coma and the family has decided to put in place a DNR order.
Question 5Which assessment would indicate possible gallbladder disease in an older adult?
a. Dull pain in the right upper quadrant region
b. Changes in color of urine or stool
c. Distention of veins in upper part of body
d. Aching muscles and tenderness in the liver
Question 6The nurse develops measures to facilitate independence in the resident who requires a wheelchair for mobility. Which of the following interventions should the nurse choose to promote independence?
A) Assure that the call light is in reach.
B) Obtain a reacher-grabber tool.
C) Offer assistive feeding devices.
D) Provide a walker for transfers.
Question 7The 80-year-old patient has fallen. The fall impacted the right arm and hip. The patient describes the fall as painful, the skin is intact, and neither edema nor redness is noted. What is the emergency department care team's best course of action?
A) Discharge the patient home with instructions to follow up with the family doctor if further pain is noted.
B) Assess the patient for fractures in spite of the absence of obvious signs or symptoms.
C) Refer the patent to physiotherapy for rehabilitation.
D) Design an exercise program to increase the patient's stamina to prevent future falls.
Question 8In which of the following situations would the use of physical restraints most likely be justified?
A) Mr. Y is agitated and aggressive while he is experiencing severe withdrawal from alcohol and is not responding to chemical sedation.
B) Mrs. U, who has a diagnosis of dementia, was found wandering outside the hospital and nurses have been unable to redirect her to stay on the unit.
C) Mr. I is delirious during the acute stage of his urinary tract infection and is ringing the call bell nearly continuously.
D) Mrs. T is frequently entering other patients' rooms and attempting to crawl into others' beds.
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