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A 6-year-old client is diagnosed with attention deficit hyperactivity disorder (ADHD). When asking this client to complete a task, what techniques should the nurse use to communicate most effectively with him?
- A. Obtain eye contact before speaking, use simple language, and have him repeat what was said. Praise him if he completes the task.
- B. Fully explain to the client the actions required of him, offer verbal praise and a food reward for task completion.
- C. Explain to the client what he is to do, the consequences if he does not comply, and follow through with praise or consequences as appropriate.
- D. Demonstrate to the client what he is to do, have him imitate the nurse's actions, and give a food reward if he completes the task.
Correct Answer: A
Rationale: Clear, simple instructions with eye contact and repetition enhance communication for a child with ADHD, and praise reinforces positive behavior.
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Prior to administering plasminogen activator (t-PA) to a client admitted with a stroke, the nurse should verify that the client: Select all that apply.
- A. Is older than 65 years.
- B. Has had symptoms of the stroke less than 3 years.
- C. Has a blood pressure within normal limits.
- D. Does not have active internal bleeding.
- E. Has not had an alcoholic beverage within the last 8 hours.
Correct Answer: C, D
Rationale: t-PA requires normal blood pressure and no active bleeding to minimize complications like hemorrhage.
The nurse reviewing a urinalysis report for a client with the diagnosis of acute kidney injury notes that the results are highly positive for proteinuria. The nurse determines that this client has which type of renal failure?
- A. Prerenal failure
- B. Postrenal failure
- C. Intrinsic renal failure
- D. Atypical renal failure
Correct Answer: C
Rationale: With intrinsic (intrarenal) renal failure, there is a fixed specific gravity and the urine tests positive for proteinuria. In prerenal failure, the specific gravity is high, and there is very little or no proteinuria. In postrenal failure, there is a fixed specific gravity and little or no proteinuria. There is no such classification as atypical renal failure.
The nurse holds the gauze pledget against an I.M. injection site while removing the needle from the muscle. This technique helps to:
- A. Seal off the track left by the needle in the tissue.
- B. Speed the spread of the medication in the tissue.
- C. Avoid the discomfort of the needle pulling on the skin.
- D. Prevent organisms from entering the body through the skin puncture.
Correct Answer: A
Rationale: Holding gauze against the injection site prevents medication leakage along the needle track, ensuring proper drug absorption.
A client with a history of schizophrenia is prescribed quetiapine (Seroquel). The nurse should monitor the client for which of the following adverse effects?
- A. Weight gain.
- B. Hypoglycemia.
- C. Bradycardia.
- D. Hypotension.
Correct Answer: A, D
Rationale: Quetiapine can cause weight gain and hypotension.
A client has primary health care provider instructions to take ibuprofen 0.4 g for mild pain. The medication bottle contains ibuprofen 200-mg tablets. How many tablets will the nurse instruct the client to take for each dose? Fill in the blank. tablets
Correct Answer: 2
Rationale: To determine the number of tablets, divide the prescribed dose by the strength per tablet: 0.4 g = 400 mg; 400 mg ÷ 200 mg per tablet = 2 tablets. Therefore, the nurse instructs the client to take 2 tablets per dose.