Nokea
Milieu therapy is best employed to perform which activity?
- A. Investigating the client's view of the world
- B. Promoting socialization skills
- C. Focusing on inappropriate behavior
- D. Providing repetitive ordinary experiences on a daily basis
Correct Answer: D
Rationale: Milieu therapy provides repetitive ordinary experiences to minimize change, reduce disruptive behavior, and promote stability.
You may also like to solve these questions
The nurse should utilize data about which of the following to provide information about the nutritional status of a client being evaluated for malnutrition?
- A. triceps skinfold measurement
- B. fasting blood glucose level
- C. hemoglobin A1c level
- D. serum lipid profile results
Correct Answer: A
Rationale: Objective anthropometric measurements such as triceps skinfold and mid-arm circumference (MAC), along with weight, are usually used to diagnose malnutrition. While all the other choices represent tests that might provide useful information, they also might be affected by variables other than malnutrition.
The PN is caring for a client with diabetes insipidus. The nurse can expect the lab work to show:
- A. elevated urine osmolarity and elevated serum osmolarity.
- B. decreased urine osmolarity and decreased serum osmolarity.
- C. elevated urine osmolarity and decreased serum osmolarity.
- D. decreased urine osmolarity and elevated serum osmolarity.
Correct Answer: D
Rationale: In diabetes insipidus, the pituitary releases too much antidiuretic hormone (ADH) causing the client to produce a large amount of dilute (decreased osmolarity) urine and causing dehydration (elevated serum osmolarity). Choice 3 might be seen in a client with SIADH (syndrome of inappropriate ADH). Choices 1 and 2 generally don't occur- urine and serum osmolarity typically move in opposite directions.
In alcoholics with anemia:
- A. pernicious anemia is more common than folic acid deficiency.
- B. iron deficiency and folic acid deficiency can coexist.
- C. the alcohol interferes with iron absorption.
- D. oral vitamin replacement is contraindicated.
Correct Answer: B
Rationale: The ingestion of nonfood substances (alcohol) can lead to a clinical iron deficiency and might actually be the first sign of a problem. The client might substitute alcohol for a nutrition program that fosters a positive health habit.
What significant event occurs in the orientation phase of a nurse-client relationship?
- A. establishment of roles
- B. identification of transference phenomenon
- C. placement of the client within the client's family structure
- D. client agreement that the nurse has the authority in the relationship
Correct Answer: B
Rationale: Transference phenomena are intensified in relationships with authority, such as physicians and nurses. Common positive transferences include desire for affection and gratification of dependency needs. Common negative transferences include hostility and competitiveness. These transferences must be recognized and resolved before growth and positive change can be undertaken in the working stage.
A person using over-the-counter nasal decongestant drops who reports unrelieved and worsening nasal congestion should be instructed to:
- A. switch to a stronger dose of the medication.
- B. discontinue the medication for a few weeks.
- C. continue taking the same medication, but use it more frequently.
- D. use a combination of medications for better relief.
Correct Answer: B
Rationale: Prolonged use of decongestant drops (3 to 5 days) can lead to rebound congestion, which is relieved by discontinuing the medication for 2 to 3 weeks. Nasal congestion results from dilation of nasal blood vessels due to infection, inflammation, or allergy. With this dilation, there is a transudation of fluid into the tissue spaces, resulting in swelling of the nasal cavity. Nasal decongestants (sympathomimetic amines) stimulate the alpha-adrenergic receptors, producing vascular constriction (vasoconstriction) of the capillaries within the nasal mucosa. The result is shrinking of the nasal mucous membranes and a reduction in fluid secretion (runny nose). Decongestants can make a client jittery, nervous, or restless. These side effects decrease or disappear as the body adjusts to the drug. When nasal decongestants are used for longer than 5 days, instead of the nasal membranes constricting, vasodilation occurs, causing increased stuffy nose and nasal congestion. The nurse should emphasize the importance of limiting the use of nasal sprays and drops. As with any alpha-adrenergic drug (for example, decongestants), blood pressure and blood glucose levels can increase. These drugs are contraindicated and should only be used with extreme caution for clients with hypertension, cardiac disease, hyperthyroidism, and diabetes mellitus.