Nokea
A two-year old has been in the hospital for 3 weeks and seldom seen family members due to isolation precautions. Which of the following hospitalization changes is most likely to be occurring?
- A. Guilt
- B. Trust
- C. Separation anxiety
- D. Shame
Correct Answer: C
Rationale: Separation anxiety can easily occur after six months during hospitalization.
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Herbal therapy has several indications for use. Primarily, herbal therapy is:
- A. used to treat many common complaints and diseases.
- B. used to promote certain types of low-carb diets.
- C. used as an adjunct to medications.
- D. used to create a diet without salt and carbohydrates.
Correct Answer: A
Rationale: Herbal therapy is used to treat many common complaints and diseases.
The nurse is caring for a dying client who has persistently requested that the nurse 'help her to die and be in peace.' According to the Code of Ethics for Nurses, the nurse should:
- A. Ask the client whether she has signed the advance directives document.
- B. Tell the client that he or she will ask another nurse to care for her.
- C. Instruct the client that only a physician can legally assist a suicide.
- D. Try to make the client as comfortable as possible, but refuse to assist in death.
Correct Answer: D
Rationale: Try to make the client as comfortable as possible but refuse to assist in death. One of the competencies necessary for nurses to have in giving high quality care to clients/families during the end of life care is: apply legal and ethical principles in the analysis of complex issues and end-of-life care, recognizing the influence of personal values, profession codes, and client preferences.
A client is assessed by the nurse as experiencing a crisis. The nurse plans to:
- A. allow the client to work through independent problem-solving.
- B. complete an in-depth evaluation of stressors and responses to the situation.
- C. focus on immediate stress reduction.
- D. recommend ongoing therapy.
Correct Answer: C
Rationale: A crisis is an acute, time-limited state of disequilibrium resulting from a situational, developmental, or societal source of stress. Utilizing the nursing process, the nurse should assist clients to work through a crisis to its resolution and restore their precrisis level of functioning.
Appropriate care for a client with neutropenia includes:
- A. plenty of fresh fruits and vegetables.
- B. a semi-private room.
- C. wearing a mask when out of the room.
- D. routine hand washing.
Correct Answer: C
Rationale: When a client is neutropenic, they lack the ability to fight off infection. The mask is to prevent exposure to any upper-respiratory infections.
A successful resolution of the nursing diagnosis Negative Self-Concept (related to unrealistic selfexpectations) is when the client can:
- A. report a positive self-concept.
- B. identify negative thoughts.
- C. recognize positive thoughts.
- D. give one positive cue with each negative cue.
Correct Answer: A
Rationale: The problem statement is Negative Self Concept. A successful resolution of the problem is when the client can report a positive self-concept. When the nurse determines how the client perceives himself, effort should be directed to reinforce self-worth and promote a positive self-concept, including helping a client to identify areas of strength. Assisting the client to evaluate himself and make behavior changes is a nursing intervention.