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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Nursing considerations when caring for African-American clients include that:
- A. families are generally distant and unsupportive
- B. special hair, skin, and nail care might be required
- C. fad diets are a cultural norm
- D. clients are generally future-oriented
Correct Answer: B
Rationale: African-American clients may require specific hair, skin, and nail care due to unique characteristics like tightly coiled hair or higher risk of keloid scarring. The other options are stereotypes or incorrect: families are often supportive, fad diets are not a cultural norm, and future orientation is not a defining trait.
A nurse is reviewing a patient's medical record. The record indicates the patient has limited shoulder flexion on the left. Which plane of movement is limited?
- A. Horizontal
- B. Sagittal
- C. Frontal
- D. Vertical
Correct Answer: B
Rationale: Sagittal motion occurs in the midline plane of the body.
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.
Two staff nurses were considered for promotion to head nurse. The promotion is announced via a memo on the unit bulletin board. When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:
- A. Conversion
- B. Regression
- C. Introjection
- D. Rationalization
Correct Answer: B
Rationale: Crying reflects regression, a return to a less mature emotional response to disappointment. Conversion involves physical symptoms, introjection is identification with another, and rationalization is justifying feelings.
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.