Nokea
A nurse is working with a dying client and his family. Which communication technique is most important to use?
- A. Reflection
- B. Clarification
- C. Interpretation
- D. Active listening
Correct Answer: D
Rationale: Active listening is the most important communication technique to use when working with a dying client and their family. This technique involves the nurse fully concentrating, understanding, responding, and remembering what is being said. By actively listening, the nurse can provide empathy, support, and validation to the client and their family members during this emotionally challenging time. This technique helps in creating a safe and supportive environment for honest and open communication, allowing the nurse to assess and address the needs and concerns of both the client and their family effectively.
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. A client is diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should anticipate which laboratory test result?
- A. Decreased serum sodium level
- B. Increased blood urea nitrogen
- C. Decreased serum creatinine level (BUN) level
- D. Increased hematocrit
Correct Answer: A
Rationale: A client with the syndrome of inappropriate antidiuretic hormone (SIADH) retains water excessively due to overproduction of antidiuretic hormone (ADH). This leads to dilutional hyponatremia, resulting in decreased serum sodium levels. Hyponatremia is a hallmark laboratory finding in patients with SIADH. Other laboratory values you might see in SIADH include decreased serum osmolality, concentrated urine with a high sodium concentration, and normal renal function tests such as BUN and creatinine. Therefore, the most anticipated laboratory test result in a client with SIADH is a decreased serum sodium level.
What term describes irregular areas of deep blue pigmentation seen predominantly in newborns of African, Asian, Native American, or Hispanic descent?
- A. Acrocyanosis
- B. Erythema toxicum
- C. Mongolian spots
- D. Harlequin color changes
Correct Answer: C
Rationale: Mongolian spots are irregular areas of deep blue pigmentation commonly seen in newborns of African, Asian, Native American, or Hispanic descent. They are flat, benign, and usually appear on the lower back or buttocks, but can also occur on other parts of the body. Mongolian spots are caused by pigment that is trapped deep in the layers of the skin and tend to fade over time, usually by the age of 5 or 6, although they may persist into adulthood in some cases. It is important for healthcare providers to be aware of Mongolian spots to differentiate them from other skin conditions and provide reassurance to parents.
When caring for a client with diabetes insipidus, the nurse expects to administer:
- A. Vasopressin (Pitressin Synthetic)
- B. Regular insulin
- C. Furosemide (Lasix)
- D. 10% dextrose
Correct Answer: A
Rationale: Diabetes insipidus is a condition characterized by the inability of the kidneys to conserve water due to reduced secretion of antidiuretic hormone (ADH), also known as vasopressin. Therefore, the treatment for diabetes insipidus typically involves administering synthetic vasopressin, such as desmopressin (DDAVP) or vasopressin (Pitressin Synthetic), to replace the deficient hormone and help the kidneys reabsorb more water. Vasopressin helps regulate water balance in the body by increasing water reabsorption in the kidneys, reducing urine output, and preventing dehydration. Therefore, the nurse would expect to administer vasopressin to a client with diabetes insipidus to help manage the condition effectively.
Which of the ff nursing interventions is essential for a client during the Schilling test?
- A. Collecting urine 24-48 hrs after the client has received nonradioactive B12
- B. Collecting blood samples of 50 ml for 24-48 hrs after the client has received the nonradioactive B12
- C. Not allowing any oral fluid consumption for 24-48 hrs after the client has received nonradioactive B12
- D. Making the client lie down in the supine position for 24-48 hrs after the client has received nonradioactive B12 CARING FOR CLIENTS WITH DISORDERS OF THE HEMATOPOIETIC SYSTEM
Correct Answer: A
Rationale: During the Schilling test, which is used to evaluate the absorption of vitamin B12 in the gastrointestinal system, the essential nursing intervention is to collect urine samples 24-48 hours after the client has received nonradioactive B12. The test involves administering both radioactive and nonradioactive forms of vitamin B12 to the client. The client's ability to absorb the vitamin B12 is assessed by measuring the amount of labeled B12 in the urine over the specified time period. This helps in diagnosing conditions such as pernicious anemia or malabsorption of vitamin B12. Blood samples are not typically collected for this test, and allowing fluid consumption is important to keep the client hydrated. The client does not need to lie down in a specific position for an extended period following nonradioactive B12 administration.
A patient with a brain tumor is admitted to the medical unit to begin radiation treatments. Which nursing action should take priority?
- A. Pad the patient's side rails
- B. Teach the patient what to expect during
- C. Assess the patient's pain level radiation treatments
- D. Place the patient in isolation
Correct Answer: C
Rationale: Assessing the patient's pain level should take priority in this situation because pain management is crucial for the comfort and well-being of the patient with a brain tumor undergoing radiation treatments. Pain can affect the patient's overall quality of life and participation in treatment. By promptly assessing the patient's pain level, the nurse can determine the need for appropriate pain management interventions to ensure the patient's comfort and enhance treatment outcomes. It is important to address the patient's pain to provide holistic care and improve the patient's overall experience during the treatment process.