Nokea
After implementing nursing interventions for a client with anxiety, which expected outcome does the nurse evaluate?
- A. The client avoids all kinds of anxiety-provoking stimuli
- B. The client has no need for written instructions for follow-up care
- C. The client accurately repeats information about the drug therapy
- D. There are no consequences if anxiolytic drug is discontinued suddenly
Correct Answer: C
Rationale: Accurate understanding of drug therapy ensures compliance and safety, reducing the risk of adverse effects.
You may also like to solve these questions
A hospitalized Native American patient tells the nurse that later in the day a medicine man from his tribe is coming to perform a healing ceremony to return his world to balance. What should the nurse recognize about this situation?
- A. The patient does not adhere to an organized,formal religion.
- B. The patient’s spiritual needs may be met by traditional rituals.
- C. The patient’s spiritual needs may be met by traditional rituals.
- D. The patient may be putting his health in jeopardy by relying on rituals.
Correct Answer: B
Rationale: Traditional rituals such as those performed by a medicine man can meet the spiritual needs of Native American patients. This approach respects their cultural beliefs without undermining conventional medical treatment.
Which of the following comments should be given first consideration?
- A. There was a lot of blood and we used three bandages
- B. He pulled the stick out, just now, because it was hurting him
- C. The stick was really dirty and covered with mud
- D. He's a diabetic, so he needs attention right away
Correct Answer: B
Rationale: Pulling out the stick could have caused internal injury, making this the most urgent concern.
A client is vomiting. Which of the following actions should the nurse take first?
- A. Provide the client with an emesis basin
- B. Notify housekeeping
- C. Prevent the client from aspirating
- D. Administer an antiemetic to the client
Correct Answer: C
Rationale: The correct action for the nurse to take first is to prevent the client from aspirating. Aspiration is a serious risk when a client is vomiting as it can lead to respiratory complications. The nurse should position the client on their side to prevent aspiration of vomitus into the airway. This immediate action takes priority over providing an emesis basin, notifying housekeeping, or administering an antiemetic, which do not address the urgent need to prevent aspiration.
Why may it pose a challenge to supplement or restrict dietary consumption when providing health-related education to clients from culturally diverse populations?
- A. Cultural beliefs about food may conflict with dietary recommendations.
- B. Clients may prefer traditional healers over modern medicine.
- C. Language barriers may hinder understanding.
- D. All of the above.
Correct Answer: A
Rationale: Cultural beliefs significantly influence dietary habits, requiring sensitivity and adaptation in health education.
A client is 12 hours postoperative following colon resection. Which of the following interventions should the nurse include in the plan to reduce respiratory complications?
- A. Use incentive spirometer every 4 hours while awake.
- B. Initiate ambulation after discontinuing the NG tube.
- C. Maintain a supine position with an abdominal binder.
- D. Splint the incision to support coughing every 2 hours.
Correct Answer: D
Rationale: The correct answer is D because splinting the incision supports coughing, which helps clear secretions and prevents respiratory complications. It is essential postoperatively to prevent atelectasis and pneumonia. Using an incentive spirometer (A) aids in lung expansion but does not directly support coughing. Ambulation (B) promotes circulation but does not address respiratory concerns. Maintaining a supine position with an abdominal binder (C) may restrict diaphragmatic movement and increase the risk of respiratory complications.