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A comprehensive set of flashcards based on critical nursing concepts, vital signs monitoring, patient care, psychosocial considerations, and pharmacology.
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What is an indicator of acute stress disorder following a traumatic event?
Client experiences nightmares.
What significant emotional change in behavior should a nurse assess for in a client who recently lost family members?
Friend reporting client is not themselves.
What substance use can indicate a coping mechanism in adolescents after trauma?
Smoking marijuana to clear their mind.
Which traumatic experience has a high risk for PTSD?
Witnessing the violent death of a family member.
What finding suggests a stable vital sign for an adolescent?
Blood pressure of 122/80 mm Hg.
What symptom following trauma indicates the need for immediate mental health evaluation?
Recurrent nightmares.
What immediate nursing intervention should be taken for a client who is anxious and has experienced a traumatic event?
Assessment for suicidal thoughts.
What behavior can indicate substance abuse as a coping strategy?
Client states they smoke marijuana to manage anxiety.
What vital sign change indicates respiratory distress in a pediatric patient?
Oxygen saturation below 92%.
What medication should be administered for opioid overdose due to respiratory depression?
Naloxone.
Which finding suggests a problematic condition related to a client with a shoulder injury?
Hypotension and declining oxygen saturation.
What symptom may indicate urinary stasis in an immobile client?
Difficulty voiding or full bladder.
What nursing assessment is critical for a client after an IV fluid overload?
Monitor lung sounds for crackles.
What critical assessment finding indicates risk for sepsis in a postoperative client?
Increased temperature and heart rate.
What nursing intervention is essential for a client post-laparoscopic cholecystectomy?
Monitor vital signs frequently.
What action should be taken for a confused client experiencing hallucinations due to mental health issues?
Reduce environmental stimuli.
What behavior should a nurse observe as indicative of major depressive disorder?
Persistent hopelessness and isolation.
What condition presents with altered mental status and functional decline in older adults?
Delirium.
What statement reflects a need for further assessment in a client at risk for suicide?
Client says, 'My family would be better off if I was dead.'
What dietary instruction should a nurse prioritize for a client with anorexia nervosa?
Encourage a protein-rich diet for healing.
What is a classic symptom of hyperthyroidism indicated by an adolescent?
Unplanned weight loss despite good appetite.
What assessment finding requires immediate reporting in a client with a history of substance abuse?
Severe abdominal pain with altered mental status.
What specific vital sign should the nurse monitor in clients with known hypertension?
Blood pressure values over 140/90 mm Hg.
What side effect should a nurse monitor for in clients taking Sertraline?
Sweating and gastrointestinal symptoms.
What condition is indicated by the presence of a goiter and exophthalmos?
Hyperthyroidism.
What behavior exemplifies a risk factor for child maltreatment?
A child with cerebral palsy.
What is the best position for a postoperative patient to promote lung expansion?
High Fowler's position.
What is the primary nursing action for a patient exhibiting signs of anaphylaxis?
Administer epinephrine immediately.
What should be the first action after witnessing a patient eviscerating?
Cover the wound with a sterile, moist dressing.
What is the appropriate response for a pediatric nurse when discussing risk factors for physical injuries?
Discuss the proper use and safety of furniture.
What common sign indicates an acute reaction due to medication overdose?
Tachycardia and hypertension.
What action should a nurse prioritize when a client shows signs of hypovolemic shock?
Initiate intravenous fluid resuscitation.
What is an appropriate teaching point for a newly diagnosed patient with diabetes?
Understand the role of blood glucose monitoring.
What statement is indicative of an effective teaching session on managing pain for a client?
I can apply a cold pack to help manage pain.
What could indicate inadequate oxygenation in a patient?
Oxygen saturation less than 92%.
What assessment finding in older adults requires immediate follow-up?
Cool skin temperature with altered mental status.
What precaution is essential for a child with a recent diagnosis of Clostridium difficile?
Implement strict hand hygiene and contact precautions.
What is the expected action for the provider regarding a patient with chest pain history?
Order an ECG and cardiac enzymes.
What information is crucial to convey to a nursing assistant about a patient requiring mobility assistance?
Assure a safe environment during ambulation.
What symptom indicates a patient with dehydration due to diarrhea?
Decreased urine output and skin turgor.
What critical experience increases the risk for suicide in adults?
Job loss and hopelessness.
What common medication side effects should one be aware of regarding SSRIs?
Nausea and gastrointestinal upset.
What should a nurse do for a patient demonstrating significant anxiety upon hospitalization?
Engage in therapeutic communication to address concerns.
What therapeutic intervention is suitable for a child experiencing separation anxiety?
Encourage the child to have a comforting item from home.
What statement is accurate regarding the perioperative care of older adults?
Monitor for potential postoperative delirium.
What should be the nurse's first response when a patient reports a severe headache after an elective procedure?
Assess the patient's level of pain thoroughly.
What immediate action should a nurse take for a client with severe nausea and vomiting?
Administer IV fluids to prevent dehydration.
What information is essential for a nurse to document following a client fall?
Circumstances of the fall and immediate assessment findings.
What potential complication should be monitored post-surgical intervention for gallbladder removal?
Evaluate for bile leakage or jaundice.
What intervention can minimize the risk of delirium in hospitalized elderly patients?
Reorient the patient frequently and involve family.