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A 13-year-old client is dying of cancer and struggling with the emotional aspects of this. When providing care for this client, the nurse should incorporate the developmental tasks for this age. According to Erikson's developmental model, the child normally is expected to be working on which of the following psychosocial issues?
- A. Identity vs. role confusion.
- B. Intimacy vs. isolation.
- C. Industry vs. inferiority.
- D. Autonomy vs. shame and doubt.
Correct Answer: A
Rationale: Adolescents (ages 12–18) focus on identity vs. role confusion, developing a sense of self and personal identity.
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Sulfadiazine has been ordered for a client who has a urinary tract infection. Which of the following recommend is most appropriate for administering sulfonamides?
- A. Encourage the client to take the medication with meals.
- B. Instruct the client to drink at least 8 glasses of water a day.
- C. Measure the client's urine output.
- D. Instruct the client that the urine may turn reddish orange.
Correct Answer: B
Rationale: Adequate hydration (8 glasses of water daily) prevents crystalluria, a complication of sulfonamides.
A client has started taking amiodarone (Cordarone). The nurse should inform the client that periodic laboratory tests will be done to monitor the client's:
- A. Hemoglobin.
- B. Liver enzymes.
- C. Creatine kinase (CK) concentration.
- D. Renal function.
Correct Answer: B
Rationale: Amiodarone can cause hepatotoxicity, so periodic monitoring of liver enzymes is necessary to detect potential liver damage.
Which action is included in the accurate procedure for administering heparin sodium subcutaneously?
- A. Injecting the medication via an infusion device
- B. Massaging the injection site after administration
- C. Injecting the medication 1 inch from the umbilicus
- D. Avoiding aspiration before administration of the medication
Correct Answer: D
Rationale: Aspiration before administration of heparin sodium, an anticoagulant, should be avoided. Heparin administered by the subcutaneous route does not require an infusion device. The injection site is above the iliac crest or in the abdominal fat layer. It is injected at least 2 inches from the umbilicus. After administration, the needle is withdrawn, pressure is applied to the injection site, but the site is not massaged. Injection sites are rotated.
A client with a history of chronic kidney disease is admitted with hyperkalemia. The nurse should prioritize which of the following interventions?
- A. Administer insulin and glucose.
- B. Restrict potassium-rich foods.
- C. Administer a loop diuretic.
- D. Monitor for dysrhythmias.
Correct Answer: D
Rationale: Monitoring for dysrhythmias is the priority, as hyperkalemia can cause life-threatening cardiac arrhythmias.
A family has been notified that their son is brain dead, and the physician has discussed the possibility of donating organs. The nurse should collaborate with the physician to contact which referral source that is responsible for organ recovery in the United States?
- A. Organ and Tissue Procurement Organizations.
- B. American Transplant Association.
- C. American Hospice Foundation.
- D. American Association of Critical-Care Nurses.
Correct Answer: A
Rationale: Organ and Tissue Procurement Organizations are responsible for coordinating organ recovery in the United States, as they manage the donation process and ensure compliance with regulations.