A nurse is caring for a 68-year-old client admitted with sev…
A nurse is caring for a 68-year-old client admitted with severe vomiting and diarrhea for 3 days. Laboratory results show decreased blood pressure, increased heart rate, and elevated serum sodium. Which physiological response is the primary mechanism attempting to restore extracellular fluid volume?
Read DetailsA nurse evaluates a 42-year-old client who recently transiti…
A nurse evaluates a 42-year-old client who recently transitioned from day shift to permanent night shift work (11 p.m. to 7 a.m.). The client reports difficulty sleeping during the day despite blackout curtains, decreased appetite, and a 5-pound weight loss over 3 weeks. Which physiological change best explains these manifestations?
Read DetailsA nurse evaluates a 58-year-old client with progressive hear…
A nurse evaluates a 58-year-old client with progressive hearing loss who recently stopped attending weekly card games with friends and declined a family reunion invitation. The client states, “It’s just easier to stay home where I don’t have to struggle to understand everyone.” The client’s spouse reports the client seems withdrawn and “not like themselves anymore.” Which wellness dimension is MOST significantly impacted by this client’s sensory alteration?
Read DetailsA nurse cares for a postoperative client (day 2) with a Stag…
A nurse cares for a postoperative client (day 2) with a Stage 2 pressure injury on the right hip and a 4 cm area of blanchable erythema on the sacrum. The client rates pain as 8/10 and states, “I’m afraid to move because it hurts too much.” Physical therapy is scheduled in 30 minutes. Which nursing action demonstrates appropriate clinical judgment in priority setting?
Read DetailsA nurse evaluates four clients for aspiration risk during me…
A nurse evaluates four clients for aspiration risk during mealtime. Client A has Parkinson disease with intact gag reflex and normal alertness. Client B had a stroke 2 days ago with decreased level of consciousness and difficulty managing saliva. Client C has GERD with normal swallowing and full alertness. Client D has mild dementia with intact cough reflex and normal voice quality. Which client requires the most immediate aspiration precautions?
Read DetailsA nurse is teaching a family caregiver about assessing their…
A nurse is teaching a family caregiver about assessing their elderly client’s skin for early signs of pressure injury development at home. Which of the following assessment techniques and considerations are appropriate for the caregiver to learn and implement? Select all that apply.
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