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A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?
- A. People in middle adulthood often find satisfaction in nurturing and guiding young people.
- B. It's normal to feel this way; it will pass.
- C. You should focus on finding new activities to fill your time.
- D. Your children will always need you in some way.
Correct Answer: A
Rationale: The correct response is A. Middle adulthood is a stage where individuals often experience generativity, finding fulfillment in guiding and nurturing others. By acknowledging this aspect, the nurse can help the client explore opportunities to engage in activities that provide a sense of purpose and satisfaction. Choice A validates the client's feelings and offers a constructive way to address them. Choices B, C, and D do not address the client's emotional need for purpose and may not encourage the client to seek meaningful ways to address their feelings of uselessness.
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A client requires gastric decompression, and a nurse is inserting an NG tube. Which action should the nurse take to verify proper placement of the tube?
- A. Assess the client for a gag reflex
- B. Measure the pH of the gastric aspirate
- C. Place the end of the NG tube in water to observe for bubbling
- D. Auscultate 2.5 cm (1 in) above the umbilicus while injecting 15 mL of sterile water
Correct Answer: B
Rationale: Measuring the pH of the gastric aspirate is the most reliable method to confirm proper placement of an NG tube. Gastric fluid has an acidic pH, typically ranging from 1 to 5. Assessing the client for a gag reflex (choice A) is important for airway protection but does not confirm tube placement. Placing the NG tube in water to observe for bubbling (choice C) is incorrect and not a reliable method for verifying placement. Auscultating 2.5 cm above the umbilicus while injecting sterile water (choice D) is an outdated method and is not recommended for verifying NG tube placement.
The healthcare professional prepares a 1,000 ml IV of 5% dextrose and water to be infused over 8 hours. The infusion set delivers 10 drops per milliliter. The healthcare professional should regulate the IV to administer approximately how many drops per minute?
- A. 80
- B. 8
- C. 21
- D. 25
Correct Answer: C
Rationale: To calculate the drops per minute for the IV infusion, first determine the total drops to be infused over 8 hours. 1,000 ml to be infused over 8 hours means 125 ml per hour (1000 ml / 8 hours = 125 ml/hr). Since the infusion set delivers 10 drops per ml, 125 ml/hr x 10 drops/ml = 1250 drops/hr. To find drops per minute, divide the drops per hour by 60 (minutes in an hour): 1250 drops/hr / 60 minutes = 20.83 drops/minute, which rounds up to 21 drops per minute (Option C). This rate ensures the correct infusion rate over 8 hours. Choices A, B, and D are incorrect calculations and do not provide the appropriate infusion rate needed to administer the IV over the specified time period.
A client is expressing anger over his diagnosis of colorectal cancer. Which of the following actions should the nurse take?
- A. Discuss the risk factors for colorectal cancer.
- B. Focus teaching on addressing the client's anger and emotional response.
- C. Provide the client with emotional support and reassurance about his feelings.
- D. Reassure the client that this is an expected response to grief.
Correct Answer: D
Rationale: The correct answer is D. During the anger stage of grief, it is essential for the nurse to reassure the client that anger is a normal reaction to a cancer diagnosis. This validation of the client's emotions can help in providing emotional support. Choice A is incorrect because discussing risk factors for colorectal cancer does not address the client's current emotional state. Choice B is incorrect because focusing teaching on the client's future management does not directly address the client's need for emotional support in the present. Choice C is incorrect because providing written information about loss and grief phases is not as immediately comforting as directly reassuring the client about his feelings of anger.
A healthcare professional is caring for a group of clients. Which of the following measures should the professional take to prevent the spread of infection?
- A. Place a client with TB in a room with negative pressure airflow
- B. Use a disposable gown for contact precautions
- C. Place a client with MRSA in a private room
- D. Use a mask for clients with influenza
Correct Answer: A
Rationale: Tuberculosis is an airborne infection, and placing a client with TB in a room with negative pressure airflow helps prevent the spread of the infection by containing the pathogens. This measure is crucial as it prevents the dissemination of TB droplet nuclei to other areas. Choice B, using a disposable gown for contact precautions, is important for preventing the transmission of infections spread by direct or indirect contact. Choice C, placing a client with MRSA in a private room, is essential to prevent the spread of MRSA through contact with others. Choice D, using a mask for clients with influenza, helps prevent the spread of influenza through respiratory droplets. However, negative pressure airflow is specifically required for airborne infections like TB, making it the most appropriate choice in this scenario.
When developing a plan of care for a client with dementia, what should the LPN/LVN remember about confusion in the elderly?
- A. It is not a normal part of aging.
- B. It often follows relocation to new surroundings.
- C. It is primarily due to changes in the brain associated with the disease.
- D. It cannot be prevented or cured by adequate sleep alone.
Correct Answer: B
Rationale: When caring for a client with dementia, it is crucial to understand that confusion often arises after relocating to new surroundings. This change can disrupt familiar routines and trigger increased disorientation and confusion. Choice A is correct because confusion in the elderly is not a normal part of aging. Choice C is incorrect because confusion in dementia is primarily due to changes in the brain associated with the disease, not just irreversible brain pathology. Choice D is incorrect because while adequate sleep is important for overall health, it alone cannot prevent or cure confusion associated with dementia.