Nokea
A client's husband expresses concern that his dying wife keeps saying, 'I have to go to the store.' Which of the following statements by the nurse will be most effective in assisting the husband to understand the dying process?
- A. Many dying clients are restless and can be treated with sedatives.
- B. The client may be fighting death and you should leave her alone.
- C. Comments related to going somewhere or leaving on a trip are common in dying clients.
- D. Decreased circulation and lack of oxygen to the brain often causes delirium.
Correct Answer: C
Rationale: Statements about leaving or going somewhere are common in dying clients, reflecting their subconscious preparation for death, and this explanation helps the husband understand the behavior.
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Which of the following represents the most appropriate nursing intervention for a client with pruritus caused by cancer or the treatment?
- A. Administration of antihistamines.
- B. Steroids.
- C. Silk sheets.
- D. Medicated cool baths.
Correct Answer: D
Rationale: Medicated cool baths soothe the skin and reduce pruritus, a common symptom in cancer patients, without the systemic effects of antihistamines or steroids.
Which of the following should the nurse include in the discharge plan for a client with multiple sclerosis who has an impaired peripheral sensation?
- A. Carefully test the temperature of bath water.
- B. Avoid kitchen activities because of the risk of injury.
- C. Avoid hot water bottles and heating pads.
- D. Inspect the skin daily for injury or pressure points.
- E. Wear warm clothing when outside in cold temperatures.
Correct Answer: A,C,D,E
Rationale: Testing bath water temperature (A), avoiding hot water bottles/heating pads (C), daily skin inspection (D), and wearing warm clothing (E) prevent injury due to impaired sensation. Avoiding kitchen activities entirely is overly restrictive.
A client with a recent amputation reports phantom limb pain. Which intervention should the nurse implement first?
- A. Administer prescribed gabapentin.
- B. Apply a cold pack to the stump.
- C. Distract the client with music.
- D. Explain the nature of phantom pain.
Correct Answer: D
Rationale: Explaining phantom pain validates the client's experience, addressing anxiety before other interventions.
A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During preoperative teaching, the nurse is reinforcing information about the surgical procedure. Which of the following explanations is most accurate?
- A. The procedure will result in enlargement of the pyloric sphincter.
- B. The procedure will result in anastomosis of the gastric stump to the jejunum.
- C. The procedure will result in removal of the duodenum.
- D. The procedure will result in repositioning of the vagus nerve.
Correct Answer: B
Rationale: The Billroth II procedure involves anastomosis of the gastric stump to the jejunum, bypassing the duodenum. The other options are incorrect descriptions of the procedure.
The development of a culturally sensitive health education program for the socioeconomically disadvantaged requires the nurse to:
- A. Locate the program at an existing government facility.
- B. Integrate folk beliefs and traditions into the content.
- C. Prepare materials in the primary language of the program sponsor.
- D. Exclude community leaders from initial planning efforts.
Correct Answer: B
Rationale: Integrating folk beliefs and traditions ensures the program is culturally relevant and increases acceptance and effectiveness among socioeconomically disadvantaged populations.