Nokea
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. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
- B. Encourage the client to explore the reasons behind feeling useless.
- C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
- D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'
Correct Answer: A
Rationale: The correct answer is A because it validates the client's feelings by acknowledging the common experience of middle adults feeling a sense of purpose through nurturing others. This response shows empathy and understanding, which can help the client feel heard and supported.
Choice B is incorrect because it immediately delves into exploring the reasons behind the feelings without first acknowledging or validating them. This approach may come off as dismissive or insensitive.
Choice C is incorrect because it brushes off the client's feelings by emphasizing the positive aspect of children becoming independent, without addressing the client's emotional distress.
Choice D is incorrect because it makes a generalization about happiness related to children leaving home without directly addressing the client's specific feelings of uselessness. It does not acknowledge or validate the client's emotions.
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The complexities of the current health care delivery systems require a variety of leadership styles. Which of the following leadership styles would be most effective in this environment?
- A. Autocratic leadership
- B. Laissez-faire leadership
- C. Transactional leadership
- D. Transformational leadership
Correct Answer: D
Rationale: The correct answer is D: Transformational leadership. In the current health care environment, transformational leadership is most effective as it focuses on inspiring and motivating individuals to achieve a common goal through innovation and vision. This style encourages creativity, adaptability, and collaboration, which are essential in navigating the complexities of the health care delivery systems. Transformational leaders empower their team members, foster a culture of continuous improvement, and drive positive change. Autocratic leadership (A) is too controlling, Laissez-faire leadership (B) lacks direction and accountability, and Transactional leadership (C) focuses on rewards and punishments rather than inspiring and developing individuals.
A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?
- A. Hypotension
- B. Distended neck veins
- C. Slow capillary refill
- D. Weak, thready pulse
Correct Answer: B
Rationale: The correct answer is B: Distended neck veins. When a client has fluid volume excess, there is an accumulation of fluid in the intravascular space, leading to increased venous pressure. Distended neck veins are a classic sign of fluid overload as they indicate increased central venous pressure. Hypotension (A) is more commonly associated with fluid volume deficit. Slow capillary refill (C) and weak, thready pulse (D) are indicative of poor tissue perfusion, which is more commonly seen in fluid volume deficit rather than excess.
A supervisor is restricting the flow of communication between staff. This has resulted in the staff having two very opposite directions. The supervisor's actions are known as which type of force?
- A. Opposing force
- B. Driving force
- C. Restraining force
- D. Restrictive force
Correct Answer: C
Rationale: The correct answer is C: Restraining force. In this scenario, the supervisor's actions of restricting communication act as a restraining force, hindering the flow of information and causing conflicting directions among the staff. A restraining force limits the ability of individuals or groups to achieve their goals by imposing obstacles or constraints. Opposing force (A) implies a force in direct opposition, which is not the case here. Driving force (B) typically motivates action rather than restricts it. Restrictive force (D) is similar to restraining force but lacks the specific connotation of limiting communication in this context.
What is the primary purpose of a patient-centered medical home (PCMH)?
- A. To coordinate all aspects of patient care
- B. To reduce healthcare costs
- C. To implement the latest clinical guidelines
- D. To provide financial incentives for providers
Correct Answer: A
Rationale: The primary purpose of a patient-centered medical home (PCMH) is to coordinate all aspects of patient care (Choice A). This model aims to improve patient outcomes by ensuring comprehensive and coordinated care that meets the individual's needs. PCMH focuses on enhancing patient-provider communication, care coordination, and patient engagement to deliver high-quality care. Choices B, C, and D are incorrect because while PCMH may indirectly contribute to reducing healthcare costs and implementing clinical guidelines, the main focus is on improving patient care coordination and quality outcomes. Providing financial incentives for providers is not the primary purpose of PCMH, but rather a potential outcome of improved care coordination.
1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?
- A. Blood pressure
- B. Serum creatinine
- C. Chest x-ray
- D. Urine for microalbuminuria
Correct Answer: C
Rationale: Step-by-step rationale for correct answer (C):
1. Chest x-ray is not routinely recommended for monitoring complications of type 2 diabetes.
2. Annual blood pressure monitoring is crucial for assessing cardiovascular risk in diabetic patients.
3. Serum creatinine test helps evaluate kidney function, which is often impaired in diabetes.
4. Urine microalbuminuria test detects early signs of kidney damage, common in diabetes.
Summary of incorrect choices:
A: Blood pressure monitoring is essential for assessing cardiovascular risk in diabetes.
B: Serum creatinine test is important for evaluating kidney function in diabetic patients.
D: Urine microalbuminuria test helps detect early kidney damage in diabetes.