Get Answer: Nurse Assessing Comatose Question Guide

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This question relates to nurse assessing comatose and requires a structured academic response.

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Key Explanation

This topic involves nurse assessing comatose. A strong answer should include explanation, application, and examples.

Original Question

21. The nurse is assessing a comatose client which objective assessment finding might indicate that this client is experiencing pain? a. Temperature 101.8 F b. Oxygen saturation 94% c. Heart rate 115 beats/min d. Blood pressure 102/62 mm Hg 22. Which of the following age related changes places an older at risk for a urinary tract infection (UTI)? a. Increased urine flow b. Increased sphincter control c. Pelvic floor contractions d. Incomplete emptying of the bladder 23. Which of the following are common signs and symptoms of hyperglycemia? (select all that apply) a. Increased appetite b. Increased thirst c. Urinary retention d. Frequent urination e. Diaphoresis (sweating) 24. A client visits an urgent care facility with a chief complaint of shortness of breath, cough, and fever. What kind of assessment will the nurse perform? a. Time-lapsed assessment b. Focused assessment c. Emergency assessment d. Initial assessment 25. What is the priority reason ISBARR is used by nurses when giving hand -off report? a. To speed up the hand-off report time b. To measure the success of hand-off report c. To accurately communicate client information 26. What are the evaluative criteria used in evaluating the client’s plan of care? a. Evidence-based practice b. Physician input on the client care c. Nursing satisfaction d. Patient outcomes from the plan of care 27. Which statement best identifies when the nurse should begin discharge planning? a. Discharge planning will begin once the client’s discharge order is written b. Discharge planning will begin once the client’s insurance company approves discharge coverage. c. Discharge planning will begin upon the client admission to the facility d. Discharge planning will begin 48 hours before the client’s tentative discharge date? 28. What is a sign or symptom of late hypoxia a. Anxiety b. Elevated respiratory rate c. Cyanosis d. Elevated blood pressure 29. The nurse understand that evaluation most directly relates to which aspect of the nursing process? a. Implementation 30. Which of the following are culturally sensitive considerations? ( select all that apply) a. Recognizing that each person holds various beliefs about pain b. Recognizing that culture is an important component of individuality c. Allowing people of different cultures the right to worship as they please

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