Nokea
A client who is terminally ill has a family member who is coping effectively with the situation. Which of the following statements should the nurse identify as an indication of effective coping?
- A. "We still have hope that everything will be okay."
- B. "This is a difficult time, but we are helping each other through this."
- C. "After he comes home, we can plan out a family reunion."
- D. "We don't need to talk about funeral arrangements at this time."
Correct Answer: B
Rationale: The correct answer is B because an effective coping strategy involves mutual support and communication within the family. This statement reflects effective coping skills as the family is shown to be helping each other through the difficult time. Choice A is incorrect as maintaining hope does not necessarily indicate effective coping. Choice C focuses on future events and may not address the current situation of coping with a terminally ill family member. Choice D avoids discussing important aspects of end-of-life planning, which may not reflect effective coping with the situation at hand.
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A client who is receiving chemotherapy for cancer treatment is experiencing nausea and vomiting. What is the best intervention for the LPN/LVN to implement?
- A. Offer the client small, frequent meals.
- B. Provide antiemetic medication as prescribed.
- C. Encourage the client to drink clear liquids.
- D. Assist the client with oral care.
Correct Answer: B
Rationale: The best intervention for a client experiencing chemotherapy-induced nausea and vomiting is to provide antiemetic medication as prescribed. This medication helps in managing and reducing nausea and vomiting, providing relief to the client. Offering small, frequent meals (Choice A) may not address the underlying cause of the symptoms. Encouraging clear liquid intake (Choice C) may not be effective in controlling nausea and vomiting associated with chemotherapy. Assisting with oral care (Choice D) is important for overall comfort but may not directly address the symptoms of nausea and vomiting.
The client is post-operative following abdominal surgery. Which of the following assessment findings would require immediate intervention?
- A. Absent bowel sounds
- B. Saturated abdominal dressing
- C. Pain level of 8/10
- D. Temperature of 100.4°F
Correct Answer: B
Rationale: A saturated abdominal dressing is a critical finding that may indicate active bleeding or wound complications. Immediate intervention is necessary to prevent further complications, such as hypovolemic shock or infection. Absent bowel sounds, though abnormal, are a common post-operative finding and do not require immediate intervention. Pain level of 8/10 can be managed effectively with appropriate pain control measures and does not indicate an urgent issue. A temperature of 100.4°F is slightly elevated but may be a normal post-operative response to surgery and does not typically require immediate intervention unless accompanied by other concerning signs or symptoms.
A healthcare provider is monitoring a client for adverse effects following the administration of an opioid. Which of the following effects should the provider identify as an adverse effect of opioids?
- A. Urinary incontinence
- B. Diarrhea
- C. Bradypnea
- D. Orthostatic hypotension
Correct Answer: D
Rationale: The correct answer is D: Orthostatic hypotension. Opioids can cause orthostatic hypotension, leading to a sudden drop in blood pressure when changing positions. This effect is due to the vasodilatory properties of opioids, which can result in decreased blood flow to the brain upon standing up. Choices A, B, and C are incorrect. Urinary incontinence and diarrhea are not typical adverse effects of opioids. Bradypnea, or slow breathing, is a potential side effect of opioid overdose or respiratory depression, but it is not a common adverse effect following normal opioid administration.
While instructing a male client's wife in the performance of passive range-of-motion exercises to his contracted shoulder, the nurse observes that she is holding his arm above and below the elbow. What nursing action should the LPN/LVN implement?
- A. Acknowledge that she is supporting the arm correctly.
- B. Encourage her to keep the joint covered to maintain warmth.
- C. Reinforce the need to grip directly under the joint for better support.
- D. Instruct her to grip directly over the joint for better motion.
Correct Answer: A
Rationale: Acknowledging that the client's wife is supporting the arm correctly is the appropriate nursing action in this scenario. By doing so, the nurse reinforces correct technique and promotes confidence. Choice B is incorrect as the issue is not about maintaining warmth. Choice C is incorrect as gripping directly under the joint is not necessary in this case. Choice D is incorrect as instructing to grip directly over the joint may not provide the best support for passive range-of-motion exercises.
The healthcare provider is planning care for a 3-month-old infant immediately postoperative following placement of a ventriculoperitoneal shunt for hydrocephalus. The healthcare provider needs to
- A. Assess for abdominal distention
- B. Maintain the infant in an upright position
- C. Begin feeding formula when the infant is alert
- D. Pump the shunt to assess for proper function
Correct Answer: A
Rationale: Assessing for abdominal distention is crucial in this situation as it can indicate a complication with the shunt or fluid accumulation. Abdominal distention may suggest an issue with the shunt placement, such as obstruction or overdrainage, which requires immediate intervention. Maintaining the infant in an upright position (Choice B) is not the priority immediately postoperatively following a ventriculoperitoneal shunt placement. Beginning formula feedings when the infant is alert (Choice C) may be appropriate but is not the priority over assessing for abdominal distention. Pumping the shunt to assess for proper function (Choice D) is not a recommended nursing intervention postoperatively and should be done by a qualified healthcare provider.