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When communicating with a client who has cognitive impairment, which of the following will Nurse Dory use?
- A. Complete explanations with multiple details
- B. Pictures or gestures instead of words
- C. Stimulating words and phrases to capture the client's attention
- D. Short words and simple sentences
Correct Answer: D
Rationale: Nurse Dory will use short words and simple sentences when communicating with a client who has cognitive impairment. This approach is effective because it helps improve understanding and comprehension for individuals with cognitive challenges. Choice A is incorrect because complete explanations with multiple details may overwhelm or confuse clients with cognitive impairment. Choice B is not the most effective option as using pictures or gestures instead of words may not always be practical or necessary. Choice C is also not ideal as stimulating words and phrases may cause distraction rather than enhance communication for clients with cognitive impairment.
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Which of the following outcome criteria is appropriate for a client with dementia?
- A. The client will return to an established schedule for activities of daily living.
- B. The client will learn new coping mechanisms to handle anxiety.
- C. The client will seek out resources in the community for support.
- D. The client will follow an established schedule for activities of daily living.
Correct Answer: D
Rationale: The correct answer is D. For clients with dementia, following an established schedule for activities of daily living is appropriate as it helps maintain routine and structure, which can be beneficial for their condition. Choice A has been rephrased to align better with the context of dementia care. Choice A is incorrect as expecting a return to a previous level of self-functioning may not be realistic for clients with dementia. Choice B is not the most appropriate outcome criteria as handling anxiety, while important, may not be the primary focus when working with clients with dementia. Choice C, seeking out resources in the community for support, is also important but may not be as directly related to the day-to-day care and management of activities for a client with dementia.
After a generalized seizure, a 27-year-old woman with epilepsy feels tired and falls asleep. This is:
- A. an ominous sign.
- B. normal and termed the postictal period.
- C. a reflection of an underlying brain tumor.
- D. only worrisome if there are focal neurologic deficits after.
Correct Answer: B
Rationale: Choice B is the correct answer. The postictal period is the phase following a seizure, characterized by symptoms like fatigue, confusion, and sleepiness. It is a normal part of the seizure process and does not necessarily indicate a serious underlying issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is expected and not an ominous sign. Choice C is incorrect as there is no indication in the scenario provided to suggest an underlying brain tumor. Choice D is incorrect because the presence of focal neurologic deficits would indeed be concerning, but the postictal state itself is a common and expected occurrence post-seizure.
Which goal is a priority for a client with a DSM-IV-TR diagnosis of delirium and the nursing diagnosis Acute confusion related to recent surgery secondary to traumatic hip fracture?
- A. The client will complete activities of daily living.
- B. The client will maintain safety.
- C. The client will remain oriented.
- D. The client will understand communication.
Correct Answer: B
Rationale: The correct answer is B: 'The client will maintain safety.' For a client with delirium, especially in the context of acute confusion post-surgery, safety is the top priority. Delirium can lead to disorientation, impaired decision-making, and increased risk of falls or accidents. Ensuring the client's safety by implementing measures to prevent harm is crucial. Choices A, C, and D are important but not the priority in this scenario. Completing activities of daily living, remaining oriented, and understanding communication are relevant goals but come after ensuring the client's safety in the presence of delirium and acute confusion.
Which of the following is a clinical manifestation in a patient with renal impairment associated with polycystic kidney disease?
- A. Suprapubic pain
- B. Periorbital edema
- C. Low serum creatinine level
- D. Palpable kidneys
Correct Answer: D
Rationale: The correct answer is D: Palpable kidneys. Polycystic kidney disease often leads to the development of multiple fluid-filled cysts within the kidneys, causing them to enlarge. Enlarged kidneys can be palpated during a physical examination. Choices A, B, and C are incorrect. Suprapubic pain is not a typical clinical manifestation of polycystic kidney disease. Periorbital edema is more commonly associated with conditions like nephrotic syndrome or heart failure. Low serum creatinine level is not expected in patients with renal impairment due to polycystic kidney disease; instead, elevated serum creatinine levels are more likely.
Which of the following findings is commonly associated with congestive heart failure?
- A. Decreased jugular venous pressure
- B. Pulmonary edema
- C. Hyperactive bowel sounds
- D. Weight loss
Correct Answer: B
Rationale: Pulmonary edema is a common finding in congestive heart failure. In congestive heart failure, the heart is unable to pump effectively, leading to fluid buildup in the lungs, causing pulmonary edema. This results in symptoms like shortness of breath, coughing, and wheezing. Choices A, C, and D are not typically associated with congestive heart failure. Jugular venous pressure is often elevated, not decreased in heart failure. Hyperactive bowel sounds and weight loss are not specific findings for congestive heart failure.