Answer to Question 1
ANS: A
Chest pain, possibly angina, indicates that tachycardia may be increasing the client's myocardial workload and oxygen demand to such an extent that normal oxygen delivery cannot keep pace. This results in myocardial hypoxia and pain. Increased urinary output and mild orthostatic hypotension are not life-threatening conditions and therefore do not require immediate intervention. The P wave touching the T wave indicates significant tachycardia and should be assessed to determine the underlying rhythm and cause; this is an important assessment but is not as critical as chest pain, which indicates cardiac cell death.
Answer to Question 2
ANS: A
The home health nurse needs to know current medications the client is taking to ensure assessment, evaluation, and further education related to these medications. The other information will not assist the nurse to develop a plan of care for the client.
The nurse is using Standard Precautions to draw blood.
The nurse assesses the patient's ability to use the walker correctly
Nurse using a stethoscope
Measuring the client’s blood pressure
The physician orders pemetrexed (Alimta) 500 mg/m2. The client’s body surface area is 2.14 ...