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During a class on religion and spirituality, the nurse is asked to define spirituality. Which statement by the nurse best describes spirituality?
- A. "Is a personal search to discover a supreme being."?
- B. "Is an organized system of beliefs concerning the cause, nature, and purpose of the universe."?
- C. "Is a belief that each person exists forever in some form, such as a belief in reincarnation or the afterlife."?
- D. "Focuses on a connection with something bigger than oneself and a belief in transcendence."?
Correct Answer: D
Rationale: Spirituality is a broad term that focuses on a connection with something greater than oneself and a belief in transcendence. It is a personal journey that arises from unique life experiences and the individual's quest to find purpose and meaning in life. The correct answer emphasizes the essence of spirituality, which involves seeking a connection with a higher power and believing in transcendence. Choices A, B, and C, on the other hand, define aspects of religion rather than spirituality. Choice A refers to a personal search for a supreme being, which is more aligned with religious beliefs. Choice B describes an organized system of beliefs about the universe, typically associated with religion. Choice C pertains to beliefs about existence after death, such as reincarnation or the afterlife, which are often religious concepts. Therefore, the best description of spirituality is focusing on a connection with something beyond oneself and a belief in transcendence.
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The nurse is preparing to assess a hospitalized patient who is experiencing significant shortness of breath. How should the nurse proceed with the assessment?
- A. Have the patient lie down to obtain an accurate cardiac, respiratory, and abdominal assessment.
- B. Obtain a thorough history and physical assessment from the patient's family member.
- C. Immediately perform a complete history and physical assessment to obtain baseline information.
- D. Examine the body areas relevant to the problem and complete the rest of the assessment after the problem has resolved.
Correct Answer: D
Rationale: When assessing a patient experiencing significant shortness of breath, it is crucial to prioritize the evaluation of areas directly related to the problem. Having the patient lie down may exacerbate the breathing difficulty. Therefore, the nurse should focus on examining the body areas pertinent to the issue, such as the respiratory and cardiac systems. Completing the rest of the assessment can be deferred until after addressing the immediate problem. Obtaining a complete history or involving family members should come after addressing the acute issue to ensure the patient's safety and comfort.
Which action is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?
- A. Listen to a patient's lung sounds for wheezes or rhonchi.
- B. Label specimens obtained during percutaneous lung biopsy.
- C. Instruct a patient about how to use home spirometry testing.
- D. Measure induration at the site of a patient's intradermal skin test.
Correct Answer: B
Rationale: Labeling specimens obtained during a percutaneous lung biopsy is a task that can be appropriately delegated to unlicensed assistive personnel (UAP) as it does not require nursing judgment. UAP can perform this task safely under the supervision of a nurse. Listening to a patient's lung sounds for wheezes or rhonchi, instructing a patient about how to use home spirometry testing, and measuring induration at the site of a patient's intradermal skin test all require nursing judgment and interpretation of findings. These tasks should be performed by licensed nursing personnel to ensure accurate assessment and appropriate intervention.
When percussing over the lungs of a 4-year-old child, the nurse hears bilateral loud, long, and low tones. How should the nurse proceed?
- A. Palpate over the area for increased pain and tenderness.
- B. Ask the child to take shallow breaths and percuss over the area again.
- C. Refer the child to a specialist because of an increased amount of air in the lungs.
- D. Consider this finding as normal for a child this age and proceed with the examination.
Correct Answer: D
Rationale: In pediatric patients, loud, long, and low tones heard when percussing over the lungs are normal findings. These percussion notes are characteristic of a child's lung due to its thin chest wall and increased air content. It is unnecessary to palpate for pain and tenderness, ask the child to take shallow breaths and repeat the percussion, or refer the child to a specialist. Therefore, the correct action is to consider these findings as normal for the child's age and continue with the examination.
The nurse is preparing to examine a 4-year-old child. Which action by the nurse is appropriate for this age group?
- A. Explain the procedures briefly to alleviate the child's anxiety.
- B. Give the child feedback and reassurance during the examination.
- C. Ask the child to undress as needed for the examination.
- D. Perform an examination of the head last.
Correct Answer: B
Rationale: For a 4-year-old child, short and simple explanations should be provided to avoid overwhelming the child. It is important to give feedback and reassurance during the examination to create a comforting environment for the child. Asking the child to undress as needed is appropriate for a thorough examination, as children at this age are usually willing to do so. Performing an examination of the head last allows the child to become more comfortable during the assessment. Therefore, the most appropriate action for a 4-year-old child is to provide feedback and reassurance during the examination, ensuring a positive experience for the child.
During the examination, it is often appropriate to offer some brief teaching about the patient's body or the examiner's findings. Which one of these statements by the nurse is most appropriate?
- A. "Your atrial dysrhythmias are under control."?
- B. "You have pitting edema and mild varicosities."?
- C. "Your pulse is 80 beats per minute, which is within the normal range."?
- D. "I'm using my stethoscope to listen for any crackles, wheezes, or rubs in your lungs."?
Correct Answer: C
Rationale: During an examination, providing brief educational information to the patient can enhance rapport, as long as the patient can comprehend the terminology. The most appropriate statement from the nurse is "Your pulse is 80 beats per minute, which is within the normal range." This statement conveys a vital sign in a way that is likely understandable to the patient. Choices A, B, and D use terminology that may be unfamiliar or confusing to the patient. Option A mentions 'atrial dysrhythmias,' which might not be clear to the patient. Option B involves terms like 'pitting edema' and 'varicosities,' which could be unfamiliar to the patient. Option D references 'crackles,' 'wheezes,' and 'rubs,' which might not be easily understood by the patient.