Nokea
A nurse is screening patients for immunizations. Which of following is not a contraindication for immunization?
- A. Seizures
- B. Fever >3 days
- C. Malignancy >3 months
- D. Illness >6 months
Correct Answer: D
Rationale: Chronic conditions are not considered a contraindication for immunization.
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The three universal spiritual needs include all of the following except:
- A. meaning and purpose.
- B. love and relatedness.
- C. forgiveness.
- D. God's permission.
Correct Answer: D
Rationale: Religious teachings help to present a meaningful philosophy and system of practices within a system of social controls having specific values, norms, and ethics. God is the center of many religions (major), but not all.
When helping a client gain insight into anxiety, the nurse should:
- A. help relate anxiety to specific behaviors.
- B. ask the client to describe events that precede increased anxiety.
- C. instruct the client to practice relaxation techniques.
- D. confront the client's resistive behavior.
Correct Answer: B
Rationale: To gain insight, the client needs to recognize causal events. The other activities focus on recognition of anxiety.
The highest incident of child abuse occurs in children in which age group?
- A. birth-3 years old
- B. 4-6 years old
- C. 6-10 years old
- D. more than 10 years old
Correct Answer: A
Rationale: Children between birth and 3 years of age have the highest rates of victimization (at 16 per 1,000 children). Girls are slightly more likely to be victims than boys.
A client who recently lost 50 pounds just received news that she is pregnant. A possible nursing diagnosis is:
- A. Actual Chronic Low Self-Esteem (related to obesity).
- B. Potential Chronic Low Self-Esteem (related to obesity).
- C. Actual Situational Low Self-Esteem (related to fear of weight regain and pregnancy).
- D. Potential Situational Low Self-Esteem (related to fear of weight regain and pregnancy).
Correct Answer: D
Rationale: If there are indications of a body image disturbance, the nursing care plan should include body disturbances, related to a functional or physical problem. The disturbance might be an anticipated one - that is, weight gain and pregnancy. Stressors can include a change in physical appearance, sexuality concerns, or an unrealistic ideal self.
Using clichés in therapeutic communication leads the client toward:
- A. viewing the nurse as human
- B. accepting himself as human
- C. self-disclosing
- D. feeling discounted
Correct Answer: D
Rationale: Clichés in communication can make clients feel dismissed or misunderstood, reducing trust and engagement in therapeutic interactions.