Nokea
The nurse assesses that a hospitalized 20-year-old college student is anxious and not able to concentrate when given self-care instructions. Which intervention should the nurse implement to assist the client to deal with the stress of hospitalization?
- A. Have one parent stay in the room when the client is anxious
- B. Encourage using a cell phone or Internet to talk with friends
- C. Contact psychiatry to discuss treatments for depression
- D. Reinforce multiple times how best to perform self-care
Correct Answer: B
Rationale: To enhance coping, the nurse should focus on the developmental needs of a young adult, which include interaction with peers. Using a cell phone or Internet to communicate with friends assists in dealing with hospitalization stress. Parental presence may be intrusive, the client shows no depression, and reinforcing self-care doesn’t address emotional needs.
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The 18 year-old tells the clinic nurse, 'Thinking about college is stressing me out. I am used to getting A’s and B’s.' Which statement should the nurse reserve until a follow-up visit with the client?
- A. Expressing your feelings of anxiety to a friend or nurse helps you cope emotionally.'
- B. I will check with the provider about prescribing paroxetine hydrochloride.'
- C. Exercise increases the release of endorphins and can enhance your sense of well-being.'
- D. If you like drawing or painting, register for an art class during your first semester in college.'
Correct Answer: B
Rationale: The nurse should reserve suggesting an antidepressant until other interventions have been tried. Paroxetine influences neurotransmitters related to anxiety, but non-pharmacological coping strategies like expressing feelings, exercise, and art therapy should be prioritized initially.
The 83-year-old tells the nurse, 'I’m not taking my medication because it’s too expensive and I really don’t need it anymore.' Before responding to the client, the nurse should consider that the most common reason for older clients to discontinue their medications is which of the following?
- A. Information about the medications is insufficient
- B. Medications alter the taste of foods that they enjoy
- C. Fear they will live longer than their resources will last
- D. They want the attention from others when they are sick
Correct Answer: C
Rationale: Fear of outliving resources is a common reason older adults stop medications, reflecting financial concerns. Lack of information, taste changes, and seeking attention are less common.
The 66-year-old client recently retired after working 30 years as a bank manager. Which statement to the nurse during a clinic visit best suggests that the client is achieving the developmental stage of 'integrity versus despair'?
- A. Now that I have some free time, I want to treat my wife to a trip to Hawaii.'
- B. I seem to be staying in bed longer and longer each day. There isn’t a reason to get up now.'
- C. I am noticing the little aches and pains more; before I was just too busy to notice them.'
- D. I get calls a few times a week for advice; my coworkers still value my suggestions.'
Correct Answer: D
Rationale: Integrity versus despair involves accepting one’s life’s worth. Valued advice from coworkers indicates positive resolution. A trip reflects generativity, staying in bed suggests despair, and aches are unrelated.
The client’s family approaches the nursing supervisor with a complaint about the NA’s inappropriate communication with their 89-year-old father. When evaluating the NA’s communication, which statements does the nurse determine most likely caused the family’s complaint? Select all that apply.
- A. Are you ready for the nurse to give you your medicine?'
- B. Would you like to go to breakfast now, Grandpa?'
- C. Would you prefer to wear the brown socks today?'
- D. Your family will be visiting today. Isn’t that nice?'
- E. Honey, this is your bath day. Are you ready to go?'
Correct Answer: B;D;E
Rationale: Grandpa,' 'Isn’t that nice?,' and 'Honey' are infantilizing or clichéd, likely causing the complaint. Other statements are appropriate.
The nurse is interviewing a family member of the hospitalized 90-year-old client to assess for common problems associated with an increased risk for falling. Which questions should the nurse ask? Select all that apply.
- A. Has your mother fallen within the past year?'
- B. Has your mother had her annual influenza vaccine?'
- C. When was the last time your mother took a pain pill?'
- D. Does your mother have any problems with urination?'
- E. Does your mother have difficulty falling asleep at night?'
Correct Answer: A;C;D;E
Rationale: Questions about past falls, pain medication, urination issues, and sleep disorders assess fall risk factors. Influenza vaccine is unrelated.