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A nurse reviewed a client's progress in smoking cessation, praising the client for being successful but suggesting the client might stop having coffee in the morning since that caused an urge to smoke. Following this session, the client appeared upset and complained that the nurse believed she was doing poorly because she wanted a cigarette with her morning coffee. Which type of cognitive distortion is the client exhibiting?
- A. Overgeneralization
- B. Mental filter
- C. All-or-nothing thinking
- D. Magnification
Correct Answer: B
Rationale: Mental filter (B) involves focusing only on the negative (nurse's suggestion) and ignoring praise, leading to the client's misinterpretation.
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A client with an esophageal tamponade develops symptoms of respiratory distress, including inspiratory stridor. The nurse should give priority to:
- A. Applying oxygen at 4 L via nasal cannula
- B. Removing the tube after deflating the balloons
- C. Elevating the head of the bed to 45°
- D. Increasing the pressure in the esophageal balloon
Correct Answer: B
Rationale: Respiratory distress with stridor suggests airway obstruction from the tamponade, requiring immediate tube removal after deflation to restore airway patency.
An 82-year-old woman is being admitted to a long-term care facility. Her assigned nurse completes a full assessment, including calculating the risk for skin breakdown based on the Braden Scale. To determine a Braden Scale score, the nurse evaluates all of the following EXCEPT
- A. nutritional status.
- B. sensory perception.
- C. past history of skin breakdown.
- D. activity level.
Correct Answer: C
Rationale: The Braden Scale assesses sensory perception, moisture, activity, mobility, nutrition, and friction/shear. Past history of skin breakdown is not a scored category.
During the assessment of a laboring client, the nurse notes that the FHT are loudest in the upper-right quadrant. The infant is most likely in which position?
- A. Right breech presentation
- B. Right occipital anterior presentation
- C. Left sacral anterior presentation
- D. Left occipital transverse presentation
Correct Answer: A
Rationale: Fetal heart tones loudest in the upper-right quadrant suggest a breech presentation, with the fetus's heart higher in the uterus.
A 42-year-old female has thrombocytopenia with a platelet count of 75,000. The nurse should
- A. monitor for bleeding.
- B. place the client on neutropenic precautions.
- C. limit visiting hours.
- D. encourage a diet high in iron.
Correct Answer: A
Rationale: Thrombocytopenia (platelets <150,000) increases bleeding risk. Monitoring for bleeding (e.g., bruising, petechiae) is the priority.
The nurse is preparing to administer a unit of red blood cells (RBCs) to an anemic client. From starting the infusion (puncturing the blood pack) to completion, infusion of the pack should occur within which time period?
- A. 8 hours
- B. 6 hours
- C. 4 hours
- D. 2 hours
Correct Answer: C
Rationale: RBC transfusions must be completed within 4 hours to minimize bacterial growth and ensure safety.