A hospitalized client has just been informed that he has terminal cancer. He says to the nurse, 'There must be some mistake in the diagnosis.' The nurse determines that the client is demonstrating which of the following?
- A. denial
- B. anger
- C. bargaining
- D. acceptance
Correct Answer: A
Rationale: Denial (Kübler-Ross's Stages of Grieving) is the refusal to believe that loss is happening.
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A client is 36 hours post-op a TKR surgery, 270 cc's of sero-sanguinous accumulates in the surgical drains. What action should the nurse take?
- A. Notify the doctor
- B. Empty the drain
- C. Do nothing
- D. Remove the drain
Correct Answer: A
Rationale: The physician should be notified if excessive drainage is noted from the surgical site.
When questioning an elder about suspected abuse, the nurse should keep the questions:
- A. nonjudgmental.
- B. probing.
- C. confrontational.
- D. indirect.
Correct Answer: A
Rationale: Questions about suspected abuse should be direct and nonconfrontational. Indirect questions encourage denial.
A patient is complaining of severe chest pain during a stress test. Which of the following medications is the most appropriate to relieve this discomfort?
- A. Aspirin
- B. Diazoxide
- C. Procardia
- D. Mannitol
Correct Answer: C
Rationale: Procardia can provide the quickest relief of ischemic chest pain that is severe in this case.
Mrs. Owens is the 81-year-old mother of Jonathan, who is 54 years old. Jonathan has had schizophrenia since he was 16 years old. Which of Mrs. Owens's concerns is likely to predominate?
- A. Will my retirement funds outlast me?
- B. Who will handle my funeral arrangements?
- C. What will become of Jonathan when I am gone?
- D. How can I get Jonathan's physician to talk to me?
Correct Answer: C
Rationale: The mother's most prominent concern is likely to be what becomes of her son after she dies. Choice 1 is important but is not likely to be her most prominent concern. Choice 2 is also not likely to be her primary concern because the welfare of her son with schizophrenia is more important. Choice 4 is incorrect because Mrs. Owens has likely confronted and handled concerns about getting the physician to talk to her after 38 years of managing her son's care.
Which of the following services is not part of family consultation?
- A. assisting with vocational rehabilitation
- B. providing information about the client's illness
- C. teaching effective communication
- D. helping families solve problems
Correct Answer: A
Rationale: Family consultation does not involve vocational rehabilitation. It involves helping families deal with their feelings, focus, and find solutions. Choices 2, 3, and 4 are components of family consultation.
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