Nokea
A 25-year-old lawyer who is married with three young children works long hours in an effort to become a partner in the law firm. Following a recent hospitalization for a bleeding ulcer, he was referred for therapy to treat this psychophysiological disorder. On meeting with the therapist, he informed him or her that he was a busy man and did not have much time for this 'psych stuff.' When guiding the client to ventilate his feelings, the therapist can expect him to express feelings of:
- A. Guilt
- B. Shame
- C. Despair
- D. Anger
Correct Answer: D
Rationale: Repressed anger is associated with psychophysiological disorders like a bleeding ulcer, as stress and unexpressed emotions contribute to physical symptoms.
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The client is admitted with a diagnosis of molar pregnancy. Which nursing intervention is most appropriate?
- A. Monitor for vaginal bleeding
- B. Prepare for cesarean delivery
- C. Administer tocolytics
- D. Monitor fetal heart tones
Correct Answer: A
Rationale: Molar pregnancy involves abnormal trophoblastic tissue not a viable fetus and can cause significant vaginal bleeding. Monitoring for bleeding is the most appropriate intervention. Cesarean delivery tocolytics and fetal monitoring are not indicated.
A child becomes neutropenic and is placed on protective isolation. The purpose of protective isolation is to:
- A. Protect the child from infection
- B. Provide the child with privacy
- C. Protect the family from curious visitors
- D. Isolate the child from other clients and the nursing staff
Correct Answer: A
Rationale: The child no longer has normal white blood cells and is extremely susceptible to infection, necessitating protective isolation.
A client has recently been diagnosed with primary open-angle glaucoma. The nurse should tell the client to avoid taking:
- A. Aleve (naprosyn)
- B. Benadryl (diphenhydramine)
- C. Tylenol (acetaminophen)
- D. Robitussin (guaifenesin)
Correct Answer: B
Rationale: Benadryl, an antihistamine, can increase intraocular pressure, worsening primary open-angle glaucoma, so it should be avoided.
A client has had a unilateral adrenalectomy to remove a tumor. The most important measurement in the immediate post-operative period for the nurse to take is:
- A. The blood pressure
- B. The temperature
- C. The urinary output
- D. The specific gravity of the urine
Correct Answer: A
Rationale: Adrenalectomy can disrupt cortisol and aldosterone production leading to blood pressure instability (e.g. hypotension from adrenal insufficiency). Monitoring blood pressure is critical to detect and manage these changes promptly.
The nurse begins morning assessment on a male client and notices that she is unable to palpate either of his dorsalis pedis pulses in his feet. What is the first nursing action after assessing this finding?
- A. Palpate these pulses again in 15 minutes.
- B. Use a Doppler to determine presence and strength of these pulses.
- C. Document the finding that the pulses are not palpable.
- D. Call the physician and notify the physician of this finding.
Correct Answer: B
Rationale: Any time during an assessment that the nurse is unable to palpate pulses, the nurse should then obtain a Doppler and assess for presence or absence of the pulse and pulse strength, if a pulse is present.