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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Nutritional considerations as part of the nursing care plan would include all of the following except that:
- A. The diet should be semisolid to facilitate the passage of food f. Calcium should be avoided g. The patient should be sitting in an upright position during feeding h. Thick fluids should be encouraged to provide additional calories NEUROLOGIC Situation - Richard Gabatan, a 32-year-old car salesman, suffered a spinal cord injury in a motor vehicle accident resulting to paraplegia.
Correct Answer: B
Rationale: It is important to consider calcium supplementation for patients with spinal cord injuries, especially those with paraplegia, as they are at an increased risk of developing osteoporosis due to decreased weight-bearing activities. Calcium is necessary for bone health and should not be avoided in the diet of patients with spinal cord injuries. Therefore, the statement "Calcium should be avoided" is incorrect in this context as it goes against the nutritional considerations that should be included in the nursing care plan for a patient like Richard Gabatan.
Which of the following intravenous solutions is hypotonic?
- A. Normal saline
- B. Ringer's lactate
- C. 0.45% saline
- D. 5% dextrose in normal saline  A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET F
Correct Answer: C
Rationale: A hypotonic solution has a lower concentration of solutes compared to the cells in the body. 0.45% saline is hypotonic because it has a lower concentration of sodium chloride compared to the normal extracellular fluid in the body. When this solution is administered intravenously, water will move into the cells to balance the concentration gradient, potentially causing cellular swelling. A hypotonic solution is used to rehydrate cells in cases of hypernatremia or dehydration with cellular dehydration.
A 40 year old woman with aplastic anemia is prescribed estrogen with progesterone. The nurse can expect that these medications are given for which of the following reasons?
- A. To stimulate bone growth
- B. To enhance sodium and potassium
- C. To regulate fluid balance absorption
- D. To promote utilization and storage of fluids
Correct Answer: A
Rationale: Estrogen plays a crucial role in maintaining bone density and promoting bone growth in both men and women. Aplastic anemia is a condition where the bone marrow does not produce enough blood cells, leading to low blood cell counts. Estrogen therapy is often used in aplastic anemia to help stimulate bone growth and improve bone health. Additionally, estrogen can help protect against bone loss, which is important for overall bone health in individuals with this condition. Progesterone is commonly prescribed along with estrogen to provide a balanced hormonal therapy approach.
Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment, the nurse in charge detects dry mucous membranes and lethargy. What other findings suggests a fluid volume deficit?
- A. A sunken fontanel
- B. Decreased pulse rate
- C. Increased blood pressure
- D. Low urine specific gravity
Correct Answer: A
Rationale: A sunken fontanel is a classic sign of dehydration in infants. When a child is experiencing fluid volume deficit, the body's priority is to maintain blood flow to vital organs, resulting in decreased blood circulation to the skin and extremities. Consequently, decreased skin turgor and a sunken fontanel are common manifestations of dehydration. Other signs of fluid volume deficit may include dry mucous membranes, lethargy, decreased urine output, and increased heart rate.
Which of the ff nursing interventions would a nurse perform to avoid maceration from irritating drainage or the wound compresses in a client with breast abscess?
- A. Apply zinc oxide to the surrounding skin
- B. Use a binder to hold the dressing in place
- C. Support the arm and the shoulder with pillows
- D. Instruct the client not to shave the axillary hair on the side with abscess
Correct Answer: A
Rationale: Applying zinc oxide to the surrounding skin can help protect it from becoming macerated due to irritating drainage or wound compresses. Zinc oxide acts as a barrier that helps prevent moisture from affecting the skin, thus reducing the risk of maceration. It provides a protective layer and promotes healing by keeping the affected area dry and free from further irritation. It is an effective intervention to maintain skin integrity and promote optimal wound healing in clients with a breast abscess.