Nokea
A dying client is coping with feelings regarding impending death. The nurse bases care on the theory of death and dying by K¼bler-Ross. During which stage of grieving should the LPN/LVN primarily use nonverbal interventions?
- A. Anger
- B. Denial
- C. Bargaining
- D. Acceptance
Correct Answer: D
Rationale: Nonverbal interventions are primarily used during the acceptance stage according to K¼bler-Ross's theory of death and dying. During the acceptance stage, the individual is more likely to be reflective and less communicative, making nonverbal interventions more effective. Choices A, B, and C are incorrect because anger, denial, and bargaining are stages that precede the acceptance stage in K¼bler-Ross's model, where verbal communication and processing emotions play a more significant role.
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In planning care for a client with a surgical wound healing by secondary intention, the nurse can anticipate that the client will:
- A. Be at an increased susceptibility for infection
- B. Have a wound that heals more slowly
- C. Experience more pain during the healing process
- D. Require more frequent dressing changes
Correct Answer: A
Rationale: Wounds healing by secondary intention involve the gradual filling of the wound with granulation tissue, leading to a higher risk of infection due to prolonged exposure. This makes choice A the correct answer. Choices B and C are incorrect because wounds healing by secondary intention take longer to heal and often result in more pain compared to wounds healing by primary intention. Choice D is also incorrect as wounds healing by secondary intention usually require more frequent dressing changes to prevent infection and promote healing.
A healthcare professional is explaining the use of written consent forms to a newly-licensed healthcare professional. The healthcare professional should ensure that a written consent form has been signed by which of the following clients?
- A. A client who has a prescription for a transfusion of packed red blood cells.
- B. A client who is scheduled for a routine physical examination.
- C. A client who is undergoing a minor surgical procedure without anesthesia.
- D. A client who has been prescribed a new medication.
Correct Answer: A
Rationale: Correct! Written consent is required for procedures that carry significant risks, such as blood transfusions, to ensure the client's informed consent and understanding of the procedure. In this case, a transfusion of packed red blood cells is an invasive procedure that carries risks, making it essential to have the client's written consent. Choices B, C, and D do not typically require written consent as routine physical examinations, minor surgical procedures without anesthesia, and new medication prescriptions do not carry the same level of risk and complexity as a blood transfusion.
The client is receiving discharge instructions for warfarin (Coumadin). Which statement by the client indicates a need for further teaching?
- A. I will avoid eating foods high in vitamin K.
- B. I will have my blood tested regularly to monitor my INR levels.
- C. I will take the medication at the same time every day.
- D. I will use a soft toothbrush to prevent bleeding gums.
Correct Answer: A
Rationale: The correct answer is A. Clients taking warfarin need to be consistent with their vitamin K intake to maintain a balance in blood clotting. Avoiding foods high in vitamin K is essential as they can interfere with the medication's effectiveness. Choices B, C, and D are all correct statements regarding warfarin therapy. Regular blood testing to monitor INR levels ensures the medication is working effectively, taking the medication at the same time daily maintains a consistent level in the bloodstream, and using a soft toothbrush helps prevent gum bleeding due to warfarin's anticoagulant effects.
A client has had their diet prescription changed to a mechanical soft diet. Which of the following food items should the nurse remove from the client's breakfast tray?
- A. smoothie
- B. sliced banana
- C. pancakes
- D. sunny side up (fried) eggs
Correct Answer: D
Rationale: The correct answer is 'D: sunny side up (fried) eggs.' Fried eggs should be removed as they are not suitable for a mechanical soft diet due to their texture. The yolk of a fried egg is usually too hard and can be difficult for a client on a mechanical soft diet to chew and swallow. Poached or scrambled eggs are better alternatives for this diet as they are softer and easier to consume. Choices A, B, and C are all suitable for a mechanical soft diet as they are softer in texture and easier to chew and swallow.
When ambulating a frail, older adult client, the nurse should:
- A. Use the transfer belt if the client is unsteady
- B. Walk beside the client without support
- C. Encourage the client to use a walker
- D. Hold the client's arm for support
Correct Answer: A
Rationale: Using a transfer belt if the client is unsteady is essential to provide added safety and support during ambulation. This device helps the nurse assist the client in maintaining balance and prevents falls. Walking beside the client without support (choice B) may not offer enough assistance for a frail, older adult who is unsteady. Encouraging the client to use a walker (choice C) could be helpful in some cases, but if the client is unsteady during ambulation, additional support like a transfer belt is more appropriate. Holding the client's arm for support (choice D) may not provide enough stability and safety compared to using a transfer belt.