Nokea
An appropriate question when assessing a client's self-expectations about weight loss is:
- A. What makes you think you can change your eating habits?
- B. How do you feel about losing weight?
- C. How important is it that you lose weight?
- D. What do you think is a realistic weekly weight loss for you?
Correct Answer: D
Rationale: Nurses should assist clients to evaluate themselves and make behavior changes. Listening to clients, supporting clients' strengths, assisting clients to look at themselves in totality, and encouraging clients to set attainable goals should be part of the nurse-client relationship.
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A 10-month-old child is brought to the Emergency Department because he is difficult to awaken. The nurse notes bruises on both upper arms. These findings are most consistent with:
- A. wearing clothing that is too small for the child.
- B. the child being shaken.
- C. falling while learning to walk.
- D. parents trying to awaken the child.
Correct Answer: B
Rationale: Children who are shaken are frequently grasped by both upper arms. Symptoms of brain injury associated with shaking include decreased level of consciousness.
When planning care of a client who has a been diagnosed with Amphetamine Abuse, the nurse should use the knowledge that:
- A. amphetamines increase energy by increasing dopamine levels at neural synapses.
- B. amphetamines have a low risk of tolerance or addiction.
- C. amphetamines produce a 10-20-second rush followed by a 2-4-hour high.
- D. addiction to barbiturates and amphetamines is rare because they have opposite effects.
Correct Answer: A
Rationale: Amphetamines cause the release of norepinephrine and dopamine from storage vesicles into the synapse, increasing stimulation. Tolerance and withdrawal patterns are well-documented, and prolonged use can lead to psychosis.
A couple from the Philippines living in the United States is expecting their first child. In providing culturally competent care, the nurse must first:
- A. review their own cultural beliefs and biases
- B. respectfully request that the couple utilize only medically approved health care providers
- C. realize that the clients have to learn their new country's accepted medical practices
- D. study family dynamics to understand the male and female gender roles in the clients' culture
Correct Answer: A
Rationale: The nurse must first examine their own cultural biases to avoid imposing personal beliefs, ensuring culturally sensitive care. The other options assume or impose external standards without prioritizing self-awareness.
A 32-year-old female frequently comes to her primary care provider with vague complaints of headache, abdominal pain, and trouble sleeping. In the past, the physician has dutifully prescribed medication, but little else. Which of the following comments by the nurse to the physician is appropriate?
- A. Often women who are victims of domestic violence suffer vague symptoms such as abdominal pain.'
- B. Often women become offended if asked about their safety in relationships.'
- C. It is mandatory that all women be questioned about domestic violence.'
- D. How would you feel to know that her partner is beating her and you didn't ask?'
Correct Answer: A
Rationale: There is a correlation between vague symptoms, such as abdominal pain, and battered syndrome. The astute clinician should question any woman who presents with suspicious symptoms such as these. Rarely are women offended by a properly worded question, such as, 'Do you feel safe in your present relationship?' Studies show an increase in case finding when such questions are asked. It is not mandatory that all women are assessed for violence, but it is prudent that all persons new to a clinician be assessed by at least the one question noted previously. Castigating or shaming the physician typically does not improve client outcomes and might make for a difficult working environment for the nurse. Tactless comments, like the one in Choice 4, are not collegial and should be avoided.
A woman seeks assistance because she recently remembered childhood sexual abuse. The nurse should include which of the following goals for this client?
- A. prosecuting the perpetrator
- B. managing symptoms of anxiety and fear
- C. determining if the memories are real
- D. collaborating the client's story
Correct Answer: B
Rationale: The nurse's role is to help the client deal with the stress caused by the remembered abuse.