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A client visits the clinic after the death of a parent. Which statement made by the client's sister signifies abnormal grieving?
- A. "My sister still has episodes of crying, and it's been 3 months since Daddy died."?
- B. "Sally seems to have forgotten the bad things that Daddy did in his lifetime."?
- C. "She really had a hard time after Daddy's funeral. She said that she had a sense of longing."?
- D. "Sally has not been sad at all about Daddy's death. She acts like nothing has happened."?
Correct Answer: D
Rationale: Abnormal grieving is often characterized by a lack of sadness or acknowledgment of the loss. In this scenario, the statement 'Sally has not been sad at all about Daddy's death. She acts like nothing has happened' indicates abnormal grieving as it suggests a lack of emotional response or denial of the death. On the other hand, choices A, B, and C all describe normal grieving reactions: crying episodes, selective memory of the deceased, and feelings of longing after the funeral. These responses are typical in the grieving process. Therefore, choice D is the correct answer, highlighting a potential abnormality in the grieving process.
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A client with acute leukemia develops a low white blood cell count. In addition to the institution of isolation, the nurse should:
- A. Request that foods be provided in sealed single-serving packages
- B. Ask the client to wear a mask when visitors are present
- C. Prep IV sites with mild soap and water and alcohol
- D. Provide foods in sealed single-serving packages
Correct Answer: D
Rationale: For a client with acute leukemia and a low white blood cell count, preventing exposure to food contaminants is crucial due to immune suppression. Providing foods in sealed single-serving packages helps reduce the risk of contamination. Choice B is incorrect as it introduces the potential of infection from visitors. Choice A, suggesting disposable utensils, is not as effective as sealed containers in preventing food contamination. Choice C, using alcohol for prepping IV sites, is less suitable due to its drying effect and potential for skin breakdown, making sealed packages a better option for food safety.
When planning care of a client who has been diagnosed with Amphetamine Abuse, the nurse should use the knowledge that:
- A. Amphetamines increase energy by increasing dopamine levels at neural synapses.
- B. Amphetamines have a low risk of tolerance or addiction.
- C. Amphetamines produce a 10-20-second rush followed by a 2-4-hour high.
- D. Addiction to barbiturates and amphetamines is rare because they have opposite effects.
Correct Answer: A
Rationale: The correct answer is that amphetamines increase energy by increasing dopamine levels at neural synapses. Amphetamines cause the release of norepinephrine and dopamine from storage vesicles into the synapse, leading to increased stimulation. It is important to note that clear patterns of tolerance and withdrawal have not been described with amphetamines. Choice B is incorrect as prolonged or excessive use of amphetamines can lead to psychosis, indicating a potential for addiction. Choice C is incorrect as the duration of the effects of amphetamines is typically longer than 2-4 hours. Choice D is incorrect as addiction to amphetamines is not rare; in fact, drug cravings are common and can lead to relapse, indicating a significant risk of addiction.
How can the nurse best communicate to a client that he or she has been listening?
- A. restating the main feeling or thought the client has expressed
- B. making a judgment about the client's problem
- C. offering a leading question such as, 'And then what happened?'
- D. saying, 'I understand what you're saying.'
Correct Answer: A
Rationale: The best way for the nurse to communicate to a client that he or she has been listening is by restating the main feeling or thought the client has expressed. Restating helps the client validate the nurse's understanding of the communication, demonstrating active listening skills. Making judgments about the client's problem, as suggested in Choice B, can hinder effective communication by introducing bias and potential misinterpretation. Offering a leading question like in Choice C is not ideal for confirming understanding; it rather seeks more information. Choice D, simply saying 'I understand what you're saying,' may not convey active listening as effectively as restating the client's main feelings or thoughts, as it lacks the validation component present in restating.
When teaching clients with a diagnosis of Schizophrenia nearing discharge from a residential care facility, what is an essential topic to include?
- A. pathophysiology of the disease and expected symptoms.
- B. how to recognize and manage symptoms of relapse.
- C. the need to take extra medication when feeling stressed.
- D. the importance of contact with follow-up care daily.
Correct Answer: B
Rationale: When educating clients with Schizophrenia nearing discharge, it is crucial to focus on teaching them how to recognize and manage symptoms of relapse. Clients are usually aware of these symptoms, such as feeling anxious and overwhelmed, before the onset of psychosis. This early stage is vital for intervention, which involves finding a safe environment, seeking help, avoiding stressors, and reducing stimuli. Understanding and managing relapse symptoms empower clients to take proactive steps in their care. Choices A and C are not as immediate and practical as recognizing symptoms of relapse for client safety and well-being. While contact with follow-up care is important, it is not as urgent and specific as knowing how to manage relapse symptoms for immediate intervention.
In the emergency room, a nurse is responsible for triaging four clients injured in a motor vehicle accident. Which of the following clients should receive priority in care?
- A. A 10-year-old with lacerations on the face
- B. A 15-year-old with sternal bruises
- C. A 34-year-old with a fractured femur
- D. A 50-year-old with a dislocated elbow
Correct Answer: B
Rationale: The 15-year-old with sternal bruises should receive priority in care as this client might be experiencing airway and oxygenation problems. Airway issues take precedence in triage. The 10-year-old with lacerations on the face, although looking bad, is not in immediate distress. The 34-year-old with a fractured femur should be immobilized but can be seen after the client with sternal bruising. The 50-year-old with a dislocated elbow can also be seen later as dislocated elbows are not life-threatening compared to potential airway compromise.