The nurse has a multiple patient assignment on the surgical unit. ...

[cartlidgeashley]

The nurse has a multiple patient assignment on the surgical unit. When beginning the shift, the nurse needs to determine which postoperative patient should be seen first. Which one of the following patients should the nurse see first?
 
  a. The patient is reported as having a BP of 90/50 mm Hg.
  b. The patient received medication for pain ten minutes ago.
  c. The patient needs to be out of bed and ambulating.
  d. The patient requires instructions for wound care.

Question 2

A patient who is currently taking a diuretic should be informed by the nurse that he or she may experience which of the following effects?
 
  a. Nocturia
  b. Nightmares
  c. Increased daytime sleepiness
  d. Reduced REM sleep

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Answer to Question 1

A

Feedback
A The nurse who assigns priorities to action and determines to see this patient first because of a lower than normal BP for a postoperative patient is using scientifically and practice-based criteria for making a clinical judgement. This is an example of following standards. The nurse uses criteria such as the clinical condition of the patient, Maslow's hierarchy of needs, and risks involved in treatment delays to determine which patients have the greatest priority for care.
B The patient who received medication for pain ten minutes ago is not the priority.
C The patient who needs to be out of bed and ambulating is not the priority.
D The patient who requires instructions for wound care is not the priority.

Answer to Question 2

A

Feedback
A The nurse should inform the patient who is currently taking a diuretic that he or she might experience nighttime awakening because of nocturia.
B Diuretic use does not cause nightmares.
C Diuretics do not cause increased daytime sleepiness.
D Diuretics do not reduce REM sleep.

[cartlidgeashley]

Excellent

[amandalm]

TYSM