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A nurse is working with a dying client and his family. Which communication technique is most important to use?
- A. Reflection
- B. Clarification
- C. Interpretation
- D. Active listening
Correct Answer: D
Rationale: Active listening is the most important communication technique to use when working with a dying client and their family. This technique involves the nurse fully concentrating, understanding, responding, and remembering what is being said. By actively listening, the nurse can provide empathy, support, and validation to the client and their family members during this emotionally challenging time. This technique helps in creating a safe and supportive environment for honest and open communication, allowing the nurse to assess and address the needs and concerns of both the client and their family effectively.
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A client who suffered a vehicular accident a few days ago is in skeletal traction. Which nursing action would BESt promote INDEPENDENCE for this patient?
- A. tell the client to call for an analgesic before the pain felt becomes severe
- B. encourage the patient to do leg exercises within the limits of his traction
- C. provide an overhead trapeze for client use on the Balkan frame
- D. provide skin care to prevent skin breakdown
Correct Answer: B
Rationale: Encouraging the patient to do leg exercises within the limits of his skeletal traction is the best nursing action to promote independence for the client. By engaging in leg exercises, the patient can maintain muscle strength and joint flexibility, which can prevent complications such as muscle atrophy and joint stiffness. This activity empowers the client to actively participate in their own care and promotes a sense of independence and control over their health during a period of immobility. Additionally, it can help improve circulation and prevent complications related to immobility such as deep vein thrombosis.
For a client with sickle cell anemia, how does the nurse assess for jaundice?
- A. The nurse assesses mental status, verbal ability, and motor strength
- B. The nurse observes the joints for signs of swelling
- C. The nurse inspects the skin and sclera for jaundice
- D. The nurse collects a urine specimen
Correct Answer: C
Rationale: In a client with sickle cell anemia, jaundice is a common manifestation due to the breakdown of red blood cells. The nurse should inspect the skin and sclera for signs of jaundice, which presents as a yellow discoloration. This assessment helps in identifying the presence and severity of jaundice in the client, which can be indicative of ongoing hemolysis and the need for further interventions. Monitoring for jaundice is important in managing clients with sickle cell anemia to address complications early and provide appropriate care.
Olympic gymnast Ms. Slovenski sufferd a great fall and suffered a great fall and fractured her femur. Approximately after 20 hours in the hospital she became dyspneic, tachypneic, and with scattered crackles in her lung fields. She is coughing up large amounts of thick, white sputum. The nurse correctly interprets this as:
- A. respiratory compromise related to inhalation of smoke
- B. pneumonia related to prolonged bedrest
- C. fat embolism syndrome related to femur fracture
- D. hypovolemic shock related to multiple trauma
Correct Answer: C
Rationale: The symptoms described in the scenario - dyspnea, tachypnea, crackles in lung fields, and coughing up thick, white sputum - are indicative of fat embolism syndrome (FES), which occurs as a complication of long bone fractures like the femur fracture in this case. FES is characterized by the release of fat droplets into the bloodstream, which can then travel to the lungs and cause respiratory distress. The onset of symptoms typically occurs within 24-72 hours after the initial injury, making it a likely cause for Ms. Slovenski's condition. This is a medical emergency that requires prompt recognition and intervention to prevent further complications. The other options (A, B, and D) do not align with the clinical picture presented in the scenario and are less likely causes of her current symptoms.
Reggie is a teenager suffering from osteomyelitis; the nurse would expect which of the following symptoms? Select all that apply.
- A. Fever
- B. Irritability
- C. Pallor
- D. Tenderness
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client requires minor surgery for removal of a basal cell tumor. The anesthesiologist administers the anesthetic ketamine hydrochloride (Ketalar), 60g IV. After Ketamine administration, the nurse should monitor the client for:
- A. Muscle rigidity and spasms
- B. Hiccups
- C. Extrapyramidal reactions
- D. Respiratory depression
Correct Answer: A
Rationale: Ketamine hydrochloride (Ketalar) is a dissociative anesthetic that can cause muscle rigidity and spasms as a side effect. This is known as a dose-dependent reaction to ketamine administration. Monitoring for muscle rigidity and spasms is important to ensure the client's safety and to provide appropriate management if this adverse effect occurs. It is essential for the nurse to closely observe the client for any signs of muscle rigidity and spasms after the administration of ketamine.