Nokea
A patient with end-stage liver failure tells the nurse, “If I can just live to see my first grandchild who is expected in 5 months, then I can die happy.” The nurse recognizes that the patient is demonstrating which of the following stages of grieving?
- A. Prolonged grief disorder
- B. Kübler-Ross’s stage of bargaining
- C. Kübler-Ross’s stage of depression
- D. The new normal stage of the Grief Wheel.
Correct Answer: B
Rationale: The patient is expressing a desire to delay death in exchange for a significant event, characteristic of the bargaining stage in Kübler-Ross's model of grief.
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A client is hospitalized with a second episode of pulmonary embolism (PE). Recent genetic testing reveals the client has an alteration in the gene CYP2C19. What action by the nurse is best?
- A. Instruct the client to eliminate all vitamin K from the diet.
- B. Prepare preoperative teaching for an inferior vena cava (IVC) filter.
- C. Refer the client to a chronic illness support group.
- D. Teach the client to use a soft-bristled toothbrush.
Correct Answer: B
Rationale: The correct answer is B: Prepare preoperative teaching for an inferior vena cava (IVC) filter. In the context of a client with an alteration in the gene CYP2C19 and recurrent pulmonary embolism, the use of an IVC filter helps prevent blood clots from traveling to the lungs. This intervention is crucial in managing the risk of further pulmonary embolism. Teaching the client about the purpose, care, and potential complications of the IVC filter is essential for their understanding and cooperation in the treatment plan.
Incorrect Choices:
A: Instruct the client to eliminate all vitamin K from the diet. This choice is not relevant to the management of recurrent pulmonary embolism associated with a genetic alteration.
C: Refer the client to a chronic illness support group. While support is important, it is not the immediate priority in this case of managing a recurrent PE.
D: Teach the client to use a soft-bristled toothbrush. This recommendation is not directly
You have been pulled to the telemetry unit for the day. The monitor watcher informs you that the client has developed prominent U waves. Which laboratory value should you check immediately?
- A. Sodium
- B. Potassium
- C. Magnesium
- D. Calcium
Correct Answer: B
Rationale: Prominent U waves on an ECG strip are typically associated with hypokalemia (low potassium levels). Checking potassium levels is critical to address potential cardiac complications.
A healthcare professional is assessing a client who is recovering from a lung biopsy. Which assessment finding requires immediate action?
- A. Increased temperature
- B. Absent breath sounds
- C. Productive cough
- D. Incisional discomfort
Correct Answer: B
Rationale: The correct answer is B: Absent breath sounds. This finding requires immediate action because it could indicate a pneumothorax, which is a potentially life-threatening complication following a lung biopsy. Absent breath sounds suggest air trapped in the pleural space, leading to lung collapse. Immediate intervention is necessary to prevent respiratory distress.
A: Increased temperature is concerning but may indicate infection, which would require monitoring and possibly treatment, but it is not as urgent as addressing a potential pneumothorax.
C: Productive cough is common post-lung biopsy and may be managed symptomatically. It does not typically require immediate action.
D: Incisional discomfort is expected after a biopsy and can be managed with pain medication. It does not indicate a critical issue requiring immediate intervention.
A client with tuberculosis (TB) is taking isoniazid (INH). Which instruction is most important for the nurse to include?
- A. Take the medication with food to avoid stomach upset.
- B. Avoid exposure to sunlight while taking this medication.
- C. Report any numbness or tingling in extremities.
- D. Have liver function tests done regularly.
Correct Answer: D
Rationale: Step 1: Isoniazid (INH) can cause liver toxicity.
Step 2: Regular liver function tests help monitor for liver damage.
Step 3: Monitoring liver function is crucial to prevent serious complications.
Step 4: Other choices are not directly related to INH's side effects.
Summary: Choice D is correct as it directly addresses a potential serious side effect of INH. Choices A, B, and C are not directly relevant to the medication's side effects.
Match the following data with the assessment technique used to obtain the information.
- A. Normal blood flow through arteries
- B. Abnormal blood flow in carotid artery
- C. Tympany of the abdomen
- D. Pitting edema
Correct Answer: D
Rationale: The correct match depends on the technique: Auscultation detects normal/abnormal blood flow, percussion reveals tympany, and palpation identifies pitting edema.