Nokea
A client with obsessive compulsive personality disorder annoys his coworkers with his rigid-perfectionistic attitude and his preoccupation with trivial details. An important nursing intervention for this client would be:
- A. Helping the client develop a plan for changing his behavior
- B. Contracting with him for the time he spends on a task
- C. Avoiding a discussion of his annoying behavior because it will only make him worse
- D. Encouraging him to set a time schedule and deadlines for himself
Correct Answer: D
Rationale: Setting a time schedule helps the client manage perfectionistic tendencies by structuring tasks, reducing preoccupation with trivial details.
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A client has recently been diagnosed with open-angle glaucoma. The nurse should tell the client to avoid taking:
- A. Aleve (naprosyn)
- B. Benadryl (diphenhydramine)
- C. Tylenol (acetaminophen)
- D. Robitussin (guaifenesin)
Correct Answer: B
Rationale: Benadryl, an antihistamine, can increase intraocular pressure, worsening open-angle glaucoma, and should be avoided.
A client is admitted with a diagnosis of duodenal ulcer. A common complaint of the client with a duodenal ulcer is:
- A. Epigastric pain that is relieved by eating
- B. Weight loss
- C. Epigastric pain that is worse after eating
- D. Vomiting after eating
Correct Answer: A
Rationale: Duodenal ulcers typically cause epigastric pain that is relieved by eating due to buffering of gastric acid.
The nurse is teaching the mother of a newborn to care for the umbilical cord. What should the nurse advise the mother to do if the cord becomes soiled with urine or feces?
- A. Swab with alcohol.
- B. Wipe with a dry cloth.
- C. Wash with mild soap and water, rinse and dry.
- D. Swab with povidone-iodine.
Correct Answer: C
Rationale: Washing with mild soap and water, rinsing, and drying (C) cleans the umbilical cord safely without irritation. Alcohol (A) and povidone-iodine (D) may be too harsh, and a dry cloth (B) is ineffective.
A client is admitted to the medical-surgical unit with a report of severe hematemesis. The nurse should give priority to:
- A. Performing an assessment
- B. Obtaining a blood permit
- C. Initiating an IV with a large-bore needle
- D. Inserting an NG tube
Correct Answer: C
Rationale: Severe hematemesis indicates significant bleeding, requiring immediate IV access with a large-bore needle for fluid and blood resuscitation to stabilize the client.
The nurse is caring for clients on the neurology unit. What would be the MOST appropriate action for the nurse to take after noting that a client suddenly developed a fixed and dilated pupil?
- A. Reassess in five minutes.
- B. Check the client’s visual acuity.
- C. Lower the head of the client’s bed.
- D. Contact the physician.
Correct Answer: D
Rationale: implementation, fixed and dilated pupil represents a neurological emergency