A nurse is teaching a patient how to meditate. Which behavior presented by the patient indicates effective learning?
Engaging for 10 minutes every day.
Breathing quickly.
Lying on the floor.
Focusing on a particular image.
The Correct Answer is A
A. Regular engagement in meditation for 10 minutes daily indicates effective learning and practice of meditation techniques, as consistency is key to developing this skill.
B. Breathing quickly is not indicative of effective meditation, as the practice typically involves slow, deep breathing to promote relaxation.
C. While lying on the floor can be a comfortable position for some, it does not specifically indicate effective learning in meditation, as it depends on the individual’s preferences.
D. Focusing on a particular image can be a part of meditation but does not solely demonstrate effective learning without the context of regular practice and the correct breathing techniques.
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Correct Answer is A
Explanation
A. "Acute pain" is a NANDA-I approved nursing diagnosis that identifies a specific condition that nursing interventions can address.
B. "Sore throat" is a symptom rather than a nursing diagnosis and does not appear in NANDA-I.
C. "Sleep apnea" is classified as a medical diagnosis and not as a nursing diagnosis within NANDA-I.
D. "Heart failure" is also a medical diagnosis and not an approved nursing diagnosis, as it describes a condition rather than the patient's response or nursing concerns.
Correct Answer is A
Explanation
A. Hyperkalemia can lead to dangerous cardiac arrhythmias and other heart-related complications due to its effect on the electrical conduction system of the heart, making cardiac assessment the priority.
B. While neurological assessment is important in various conditions, it is secondary to assessing cardiac status in hyperkalemia.
C. Gastrointestinal symptoms can occur with hyperkalemia, but they do not pose an immediate life-threatening risk like cardiac issues do.
D. Respiratory assessment is essential in many contexts, but the immediate threat of hyperkalemia lies in its impact on heart function, making cardiac assessment the most critical.