Nokea
A client with a history of depression will be participating in cognitive therapy for health maintenance. The client asks the nurse, 'How does this treatment work?' Which statement is most appropriate for the nurse to make to the client?
- A. This treatment helps you relax and develop new coping skills.'
- B. This treatment helps you confront your fears by gradually exposing you to them.'
- C. This treatment helps you examine how your past life has contributed to your problems.'
- D. This treatment helps examine how your thoughts and feelings contribute to your difficulties.'
Correct Answer: D
Rationale: Cognitive therapy is frequently used with clients who have depression. This type of therapy is based on exploring the client's personal experience. It includes examining the client's thoughts and feelings about situations and how these thoughts and feelings contribute to and perpetuate the client's difficulties and mood. The development of new coping skills, gradually confronting fears, and reviewing one's past life in relation to your current problems are not characteristics of cognitive therapy.
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The nurse is teaching an HIV-positive client who just delivered an HIV-positive full-term infant. Which statement by the client indicates a need for further teaching?
- A. The antiviral medicines will cure my baby in about six months.
- B. There is a low risk of my baby transmitting the virus to household members.
- C. I should completely avoid breastfeeding my baby and purchase formula instead.
- D. Pneumonia and herpes simplex are common secondary infections my baby may develop.
Correct Answer: A
Rationale: HIV is not curable; antivirals manage but do not eliminate the virus. Other statements are correct regarding transmission, breastfeeding, and infection risks.
The nurse instructs a client with mild preeclampsia about home care measures. Which statement by the client indicates to the nurse that the teaching has been effective concerning the assessment of complications for preeclampsia?
- A. I need to check my weight every day at different times during the day.
- B. I need to take my blood pressure each morning and alternate arms each time.
- C. I need to check my urine with a dipstick every day for protein and call the doctor if it is 2+ or more.
- D. As long as the home care nurse is visiting me daily, I do not have to keep my next primary health care provider's appointment.
Correct Answer: C
Rationale: Classic signs of preeclampsia include hypertension and proteinuria. The client diagnosed with preeclampsia needs to be instructed to report any increases in blood pressure; 2+ proteinuria; weight gain of more than 1 pound per week; the presence of edema in the face, hands, and sacral area; and decreased fetal activity to the primary health care provider immediately to prevent worsening of the preeclamptic condition. The weight needs to be checked at the same time each day, after voiding, before breakfast, and with the client wearing the same clothes in order to obtain reliable weight readings. Blood pressure measurements need to be taken in the same arm every day in a sitting position to obtain consistent and accurate readings. It is important to keep primary health care provider appointments even if the client is receiving visits from a home care nurse.
Mrs. F has been diagnosed with hyperparathyroidism. Which of the following complications is Mrs. F at highest risk of developing?
- A. Hyponatremia
- B. Hypocalcemia
- C. Hypermagnesemia
- D. Hypercalcemia
Correct Answer: D
Rationale: The parathyroid glands regulate calcium, vitamin D, and phosphorus in the body. Hyperparathyroidism leads to excessive production of parathyroid hormone, causing the release of calcium from bones into the bloodstream, resulting in elevated blood calcium levels, known as hypercalcemia. This puts individuals at risk of developing complications such as kidney stones, bone pain, osteoporosis, and neuropsychiatric symptoms. The other options, hyponatremia, hypocalcemia, and hypermagnesemia, are not directly associated with hyperparathyroidism. Hyponatremia is low sodium levels in the blood, hypocalcemia is low calcium levels, and hypermagnesemia is high magnesium levels, which are not typically seen in hyperparathyroidism.
Two basic but important risk factors for testicular cancer are which of the following?
- A. Race
- B. Age
- C. Marital status
- D. Number of children
Correct Answer: A,B
Rationale: Two basic but important risk factors for testicular cancer are race and age. The incidence of testicular cancer is four times higher among white males than black males. It is the most common type of cancer to occur in males between the ages of 15 and 34 years. Other risk factors include a history of an undescended testis and a family history of testicular cancer. Marital status and the number of children are not risk factors for testicular cancer.
A nurse is caring for a client who is post-op day #1 after a total hip replacement. Although the client was alert with a normal affect in the morning, by lunchtime, the nurse notes the client is confused, has slurred speech, and is having trouble with her balance. Her blood glucose level is 48 mg/dl. What is the next action of the nurse?
- A. Contact the physician immediately
- B. Administer a bolus of 50 cc of D20W through the IV
- C. Administer 10 units of regular insulin
- D. Give the client 6 oz. of orange juice
Correct Answer: D
Rationale: A client with a blood glucose level of 48 mg/dl is experiencing significant hypoglycemia, as manifested by confusion, balance difficulties, and slurred speech. The nurse should work to correct this situation as rapidly as possible. The first measure that can be performed quickly and will have fast results is to give the client something to eat or drink that contains glucose, such as 6 oz. of orange juice. Administering a bolus of D20W through the IV (Choice B) would be too aggressive and could lead to complications in this scenario. Administering regular insulin (Choice C) would further lower the blood glucose level, worsening the client's symptoms. Contacting the physician (Choice A) is important, but immediate intervention to raise the blood glucose level is crucial to address the client's hypoglycemia.