Nokea
A 17-year-old female with a self-admitted opioid addiction is seen by the nurse in a mental health clinic. Which intervention would the nurse not consider in establishing a therapeutic relationship?
- A. discuss the impact of substance use
- B. require the client to attend all therapy sessions
- C. explore alternative approaches to managing stress
- D. assess the presence of other psychiatric disorders
Correct Answer: B
Rationale: Mandating attendance can undermine trust and autonomy, hindering a therapeutic relationship.
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A client diagnosed with renal cell carcinoma of the left kidney is scheduled for a nephrectomy. The right kidney appears to be normal at this time. The client is anxious about whether dialysis will ultimately be a necessity. Which information should the nurse initially provide to the client?
- A. It is very likely that the client will need dialysis within 5 to 10 years.
- B. One kidney is adequate to meet the needs of the body, as long as it has normal function.
- C. There is absolutely no chance of the client needing dialysis because of the nature of the surgery.
- D. Dialysis could become likely, but it depends on how well the client complies with fluid restriction after surgery.
Correct Answer: B
Rationale: Fears about having only one functioning kidney are common among clients who must undergo nephrectomy for renal cancer. These clients need emotional support and reassurance that the remaining kidney should be able to fully meet the body's metabolic needs as long as it has normal function. This information supports that the remaining options are inaccurate.
The nurse teaches a group of nursing students about elder abuse. Which older adult client does the nurse list as most likely to be a victim of abuse?
- A. A male diagnosed with moderate hypertension.
- B. A male with newly diagnosed cataracts.
- C. A female with advanced Parkinson disease.
- D. A female diagnosed with early stage Lyme disease.
Correct Answer: C
Rationale: Clients with advanced Parkinson disease are at higher risk for abuse due to increased dependency, physical limitations, and potential cognitive impairments, making them vulnerable to neglect or mistreatment. Other conditions listed are less likely to increase vulnerability to the same extent.
The nurse is preparing to care for a child with anemia from a culture that is different from the nurse's. Which is the best way to address the cultural needs of the child and family when the child is admitted to the health care facility?
- A. Address only those issues that directly affect the nurse's care of the child.
- B. Ask questions, and explain to the family why the questions are being asked.
- C. Explain that cultural practices need to be discontinued during hospitalization.
- D. Ignore cultural needs because they are not important to health care professionals.
Correct Answer: B
Rationale: When caring for individuals from a different culture, it is important to ask questions about their specific cultural needs and means of treatment. An understanding of the family's beliefs and health practices is essential to successful interventions for that particular family. Eliminate the options that ignore the cultural beliefs and values of the client.
Which psychosocial factor obtained during an assessment of an older client places the client most at risk for abuse?
- A. The client resides in an apartment in a low-income neighborhood.
- B. The client shows several signs and symptoms of clinical depression.
- C. The client is completely dependent on family members for both food and medicine.
- D. The client has been diagnosed with and is being treated for several chronic illnesses.
Correct Answer: C
Rationale: Elder abuse is sometimes the result of frustrated adult children who find themselves caring for dependent parents. Increasing demands by parents for care and financial support can cause resentment and a feeling of being burdened. The issues of abuse are not bound to socioeconomic status (option 1). Option 2 relates to depression rather than the risk for abuse. Option 4 relates to a physical factor rather than a psychosocial factor.
A client with arterial leg ulcers tells the nurse, 'I'm so discouraged. I have had this pain for more than a year now. The pain never seems to go away. I can't do anything, and I feel as though I'll never get better.' The nurse determines that which is the priority client concern?
- A. Fatigue
- B. Uneasiness
- C. Chronic pain
- D. An acute illness
Correct Answer: C
Rationale: The major focus of the client's complaint is the experience of pain. Pain that has a duration of more than 3 months is defined as chronic pain and does not indicate an acute illness. There are no data in the question that indicate fatigue or uneasiness.