PN Medical-Surgical Nursing Final Exam deWit 3rd edition

The home health nurse is caring for a patient with congestive heart failure (CHF). Which assessment finding should the nurse report immediately to the physician? A. Moderate shortness of breath after walking down the hall. B. A 3 pound weight gain over the course of a week. C. Heart rate of 104 beats/min after ambulating to the bathroom. D. Increase urinary output to 50 mL in the last hour. - Answer: A. Shortness of breath after walking down the hall. The nurse is caring for a patient with C. difficile infection. Which action is most important for the nurse to take? A. Only use alcohol-based hand cleanser for hand hygiene. B. Always wear an impervious mask. C. Don proper eye protection before providing care. D. Put the patient on contact plus isolation. - Answer