NCLEX- saunders comprehensive review exam Already Passed!!

the nurse is caring for a patient with a diagnosis of heart failure who suddenly complains about shortness of breath and dyspnea. the nurse should take which immediate action - elevate the head of the patients bed early sign of hypovolemic shock - increased pulse rate What should you consider when selecting an answer or determining the order of priority - using ABCs A-airway B-breathing C-circulation (exception: CPR. then remember CAB- compression, airway, breathing) use maslow hierarchy of needs theory when prioritizing - 1). basic physiological need 2). safety and security 3). love and belonging 4). self esteem 5). self actualization use the steps of the nursing process to prioritize - assessment analysis planning implementation evaluationeliminate options that contain closed ended words- - all, always, every, must, none open-ended words could possible be the correct answer - may, usually, normal, commonly, or generally look for the umbrella option - a broad or universal option respect for an individuals right to self-determination - Autonomy the obligation to do or cause no harm to another - nonmaleficence the duty to do good to others and to maintain a balance between benefits and harm - beneficence the duty to do what one has promised - fidelity obligation to tell the truth - veracity examples of negligent acts - medication errors that result in injury to client IV administration errors, such as incorrect flow rates or failure to monitor flow rate, that results in injury to client... pg. 136 instructional directives - living wills