Nokea
A behavior-modification program has been started for an adolescent with oppositional defiant disorder. Which statement describes the use of behavior modification?
- A. Distractors are used to interrupt repetitive or unpleasant thoughts.
- B. Techniques using stressors and exercise are used to increase awareness of body defenses.
- C. A system of tokens and rewards is used as positive reinforcement.
- D. Appropriate behavior is learned through observing the action of models.
Correct Answer: C
Rationale: Behavior modification for oppositional defiant disorder often uses a token economy system, where positive behaviors are reinforced with rewards to encourage compliance.
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The nurse is caring for a client with a history of a fractured humerus who is in a sling. The nurse should:
- A. Apply ice to the fracture site
- B. Encourage active range of motion
- C. Keep the arm in a dependent position
- D. Massage the arm daily
Correct Answer: A
Rationale: Ice reduces swelling and pain at the fracture site. Active motion is limited, dependent positioning increases swelling, and massage is not recommended.
Following a vaginal delivery, the postpartum nurse should observe for:
- A. Dystocia, kraurosis
- B. Chadwick's sign
- C. Fatigue, hemorrhoids
- D. Hemorrhage and infection
Correct Answer: D
Rationale: Hemorrhage and infection are critical complications to monitor post-vaginal delivery due to potential uterine or perineal issues.
The client is admitted with a diagnosis of preeclampsia. The nurse should monitor for which complication?
- A. Seizures
- B. Premature rupture of membranes
- C. Fetal macrosomia
- D. Maternal hypoglycemia
Correct Answer: A
Rationale: Preeclampsia can progress to eclampsia characterized by seizures a life-threatening complication. Premature rupture of membranes macrosomia and hypoglycemia are not directly related to preeclampsia.
The nurse is preparing to administer digoxin (Lanoxin) to a client with heart failure. The client’s heart rate is 58 beats per minute. What is the nurse’s best action?
- A. Administer the digoxin as ordered.
- B. Hold the digoxin and notify the physician.
- C. Reduce the dose by half and administer.
- D. Monitor the client for 30 minutes, then administer.
Correct Answer: B
Rationale: A heart rate of 58 bpm is below the threshold (60 bpm) for digoxin administration, as it may worsen bradycardia. Holding the dose and notifying the physician (B) is safest. Administering (A), reducing (C), or delaying (D) is inappropriate.
The nurse who is caring for a client with cancer notes a WBC of 500/mm3 on the laboratory results. Which intervention would be most appropriate to include in the client's plan of care?
- A. Assess temperature every four hours because of risk for hypothermia.
- B. Instruct the client to avoid large crowds and people who are sick.
- C. Instruct in the use of a soft toothbrush.
- D. Assess for signs of bleeding.
Correct Answer: B
Rationale: A WBC of 500/mm3 indicates severe neutropenia, increasing infection risk. Avoiding crowds and sick people (B) is critical. Hypothermia (A) is not a primary concern, soft toothbrush (C) prevents bleeding, and bleeding (D) is for thrombocytopenia.