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The Nursing Assistant Provides a Morning Assessment of the Older

Question 17

Multiple Choice

The nursing assistant provides a morning assessment of the older adult home health client. The client recently had pacemaker surgery, and the pacemaker is set at 60 beats per minute. Which data, collected by the nursing assistant, should be reported to the case manager immediately? Select all that apply.


A) Vital signs, temp 97.4°F, P 60, R 26, BP 110/70
B) Client is hallucinating and sees children playing in strawberries.
C) Urine has a strong odor and is cloudy.
D) Client has urgency and frequency of urination.
E) The pacemaker dressing is dry and intact.

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