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9. While the nurse is taking routine vital signs, she notices that the infant is having a hypercyanotic episode. What should the nurse do first?

58. A client in the emergency department reports back pain and difficulty breathing 15 minutes after a transfusion of packed red blood cells is started. What is the priority nursing intervention?

After teaching a client about lithium carbonate (Lithane), a nurse would consider the teaching successful on the basis of which client statement?

21. Norepinephrine has been prescribed for a client who was admitted with dehydration and hypotension. Which hemodynamic data indicate that the nurse should consult with the health care provider before starting the norepinephrine?

A client on an inpatient unit is diagnosed with bipolar disorder: manic episode. During a discussion in the dayroom about weekend activities, the client raises his voice, becomes irritable, and insists that plans change. What should be the nurse’s initial intervention?

A newly admitted client is diagnosed with bipolar disorder: manic episode. Which symptom related to altered thought is the nurse most likely to assess?

At a unit meeting, staff members discuss the decor for a special room for patients experiencing mania. Select the best option.

30. A client who has been involved in a motor vehicle crash arrives in the emergency department (ED) with cool, clammy skin tachycardia, and hypotension. Which intervention prescribed by the health care provider should the nurse implement first?

1.  The nurse caring for a child diagnosed with acute rheumatic fever should assess the child for which of the following?

A nurse begins the intake assessment of a client diagnosed with bipolar I disorder. The client shouts, “You can’t do this to me. Do you know who I am?” Which is the priority nursing action in this situation?