Nokea
During the health history interview, which of the following strategies is the most effective for the nurse to use to help clients feel that they have an active role in their health care?
- A. Ask clients to complete a questionnaire.
- B. Provide clients with written instructions.
- C. Ask clients for their description of events and for their views concerning past medical care.
- D. Ask clients if they have any questions.
Correct Answer: C
Rationale: Engaging clients by asking for their description of events and views on past medical care promotes active participation, fosters trust, and ensures the nurse understands the client's perspective, which is critical for patient-centered care.
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A client has been given a prescription to begin using nitroglycerin transdermal patches. The nurse instructs the client about this medication administration system and tells the client to expect which side effect?
- A. Sweating
- B. Headache
- C. Dry mouth
- D. Constipation
Correct Answer: B
Rationale: Nitroglycerin is a coronary vasodilator used in the management of coronary artery disease. A common side effect of this medication is an intense headache. Clients should be instructed about this side effect and that acetaminophen can be helpful in alleviating discomfort. The remaining options are not associated with the use of this medication.
A Hispanic client is admitted to the surgical unit from the emergency department for an appendectomy. The nurse conducts the preoperative preparations and determines that the client has difficulty understanding English. The surgeon needs to obtain the client's informed consent. The nurse course for obtaining the client's informed consent is to:
- A. Have the client call a family member to act as interpreter
- B. Have the client sign the Spanish surgical consent form
- C. Call the Spanish interpreter to translate the surgeon's explanation of the procedure, risks, and alternatives to obtain the client's consent and to answer the client's questions
- D. Notify the surgical charge nurse of the situation
Correct Answer: C
Rationale: The surgeon is required to give the client explanations and have questions answered. The nurse has no way of assessing the client's understanding without the interpreter. The client should sign the Spanish consent form only after receiving an explanation of the procedure, its risks, and alternatives. A family member cannot be relied on to translate the surgeon's instructions accurately.
The nurse is preparing to implement emergency care measures for the client who has just demonstrated signs and symptoms of a pulmonary embolism. Which primary health care provider prescription should the nurse implement first?
- A. Apply oxygen.
- B. Administer morphine sulfate.
- C. Start an intravenous (IV) line.
- D. Obtain an electrocardiogram (ECG).
Correct Answer: A
Rationale: The client needs oxygen immediately because of hypoxemia, which is most often accompanied by respiratory distress and cyanosis. The client should also have an IV line for the administration of emergency medications such as morphine sulfate. An ECG is useful in determining the presence of possible right ventricular hypertrophy. All of the interventions listed are appropriate, but the client needs the oxygen first.
The nurse walks into the room of a client who has a 'do not resuscitate' order and finds the client without a pulse, respirations, or blood pressure. What is the most appropriate action?
- A. Stay in the room and notify the nursing team for assistance.
- B. Push the emergency alarm to call a code.
- C. Dial the hospital phone number for a code.
- D. Pull the curtain and leave the room.
Correct Answer: D
Rationale: For a DNR client, no resuscitation is performed. The nurse should respectfully leave the room after ensuring privacy, notifying the team as needed for post-mortem care.
A client had a positive Papanicolaou smear and underwent cryosurgery with laser therapy. What information should the nurse provide the client as a part of discharge teaching?
- A. Pain can be relieved with opioid analgesics.
- B. Sitz baths are soothing to the irritated tissues.
- C. Vaginal discharge should be clear and watery.
- D. There should be absolutely no odor or vaginal discharge.
Correct Answer: C
Rationale: Cryosurgery is a procedure that involves freezing cervical tissues. Vaginal discharge should be clear and watery after the procedure. There is mild pain after the procedure, but opioid analgesics would not be required. Tub and sitz baths are avoided while the area is healing, which takes about 10 weeks. The client will begin to slough off dead cell debris, which may be odorous. This resolves within approximately 8 weeks.