Answer to Question 1
D
The diagnosis related to pain requires the nurse to assist the patient with comfort measures so that the patient is then willing and better able to move. Pain must be controlled before so that the patient will not be reluctant to initiate movement. The diagnosis of Reluctance to initiate movement requires interventions aimed at keeping the patient as mobile as possible and encouraging the patient to do self-care and ROM. This cannot be accomplished until comfort is achieved.
Answer to Question 2
A
Nurses must focus on building a caring relationship that allows them to learn what is important to their clients.
Gathering assessment data is not the most important aspect of knowing a client in relation to caring. Data gathering does not ensure that the nurse will be able to determine the client's per-ceptions and unique expectations. Success in knowing a client lies in the relationship that is es-tablished.
Treating discomforts quickly is not the most important aspect of knowing a client.
If the nurse is assuming the emotional needs of a client, then the nurse most likely lacks knowing of the client. It is more important to have a relationship in which the nurse can verify what emo-tional needs the client is experiencing. Knowing who clients are helps the nurse to select those caring approaches that are most appropriate to the client's needs.
Nursing history for ear assessment
Patient registration form.
Medical assistants can quickly pull up a patient record when a phone call is received.
Mechanisms of pain at the nociceptor level.
Head of a patient with tertiary syphilis.
Risk assessment codes for an HIV-infected patient.