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Which short-term goal is appropriate for a client with dependent personality disorder experiencing excessive dependency needs?

The nurse will monitor for clinical manifestations of hypercapnia in which of the following 

A prescription for formula requires 90 mL Enfamil given orally every 4 hours. What is the total volume of Enfamil to be administered in a 24 hour period? Record answer to the whole number. [BLANK-1]

A young woman who was a recent victim of sexual assault is brought into the emergency department by a friend. Which of the following is the priority nursing intervention?

The nurse has been administering 0.9% normal saline intravenous fluids as part of early goal-directed therapy protocols in a patient with severe sepsis. To evaluate the effectiveness of fluid therapy, which physiological parameters would be most important for the nurse to assess?

A client with facial burns asks the nurse if he will ever look the same. Which response is best for the nurse to provide?

A patient who has just been admitted with septic shock has a BP of 70/46, pulse 136, respirations 32, temperature 104.0° F, and blood glucose 246 mg/dl. Which of the following interventions is the priority?

A nurse hears the high pressure alarm on a ventilator for a patient with recent chest trauma. The settings on the ventilator are: Mode A/C, rate 14, 650 Vt, FiO2 40%, and PEEP 10. What should the nurse assess to ascertain the potential cause of the alarm? Select all that apply.

A client is taking methylphenidate sustained release (Ritalin SR) tablets once daily for attention deficit hyperactivity disorder (ADHD). The medication peaks in 4-7 hours and has a duration of 12 hours. At which time should the nurse instruct the client to take the prescribed dose?

A client who was extubated 2 hours ago is becoming increasingly restless. The last vital signs before extubation were pulse 88 beats/min, respirations 18 breaths/min, blood pressure 138/78 mm Hg, and PaCO2 45 mm Hg. Current vital signs include pulse 104 beats/min, respirations 26 breaths/min, blood pressure 140/80mm Hg, and PaCO2 62 mm Hg. The nurse would anticipate which of the following actions?