Nokea
A nurse is caring for a client who expresses anxiety about an upcoming surgery. What should the nurse do?
- A. Reassure the client that everything will be fine
- B. Ask the client to describe feelings
- C. Tell the client to stay positive
- D. Provide information about the surgery
Correct Answer: B
Rationale: Asking the client to describe their feelings allows the nurse to understand the specific concerns and anxieties the client is experiencing.
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A nurse is admitting a client who has recently developed fever, confusion, and a decreased level of consciousness. Which of the following actions should the nurse take first after obtaining the client's history and assessment?
- A. Identify the client's needs
- B. Start intravenous fluids
- C. Notify the provider
- D. Conduct a neurological assessment
Correct Answer: A
Rationale: Identifying the client's needs is essential to prioritize further interventions.
A nurse is teaching a client about the use of a metered-dose inhaler (MDI). Which instruction should the nurse include in the teaching?
- A. Inhale the medication deeply for 3-5 seconds
- B. Exhale forcefully before inhaling
- C. Shake the MDI vigorously before use
- D. Hold the mouthpiece 2.5-5 cm (1-2 in) in front of the mouth
Correct Answer: A
Rationale: Inhaling the medication deeply for 3-5 seconds and holding the breath for 10 seconds after inhalation ensures effective medication delivery to the lungs.
A nurse is documenting client care. Which of the following entries should the nurse identify as an example of implementation of client care?
- A. Contacted the provider to report client findings
- B. Administered medications as prescribed
- C. Reviewed the client's lab results
- D. Discussed the care plan with the family
Correct Answer: B
Rationale: Documenting that medications were administered as prescribed is an example of the implementation of client care.
A nurse is admitting a client who has meningococcal meningitis. What should the nurse do first?
- A. Initiate droplet precautions
- B. Start intravenous antibiotics
- C. Perform a complete assessment
- D. Notify the healthcare provider
Correct Answer: A
Rationale: Initiating droplet precautions is crucial to prevent the spread of infection, especially in cases of meningococcal meningitis.
A nurse is assisting with meal planning for a client who has been prescribed a mechanical soft diet. The nurse should instruct the client to avoid which of the following foods?
- A. Applesauce
- B. Mashed potatoes
- C. Orange slices
- D. Soft bread
Correct Answer: C
Rationale: Orange slices have membranes that are hard to swallow, which can be problematic for clients on a mechanical soft diet.