Nokea
The 18 year-old tells the clinic nurse, 'Thinking about college is stressing me out. I am used to getting A’s and B’s.' Which statement should the nurse reserve until a follow-up visit with the client?
- A. Expressing your feelings of anxiety to a friend or nurse helps you cope emotionally.'
- B. I will check with the provider about prescribing paroxetine hydrochloride.'
- C. Exercise increases the release of endorphins and can enhance your sense of well-being.'
- D. If you like drawing or painting, register for an art class during your first semester in college.'
Correct Answer: B
Rationale: The nurse should reserve suggesting an antidepressant until other interventions have been tried. Paroxetine influences neurotransmitters related to anxiety, but non-pharmacological coping strategies like expressing feelings, exercise, and art therapy should be prioritized initially.
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The nurse plans to teach the client progressive muscle relaxation. Prioritize the steps that the nurse should teach to correctly perform progressive muscle relaxation.
- A. Relax the feet, imagining the tension flowing out with each exhalation
- B. Lie down in a quiet place where you are undisturbed
- C. Contract the muscles of your feet first as you inhale and hold the contraction briefly
- D. Relax your body, allowing it to feel heavy
- E. Lie still for a few minutes after the contraction and relaxation of all muscles
- F. Imagine the tension flowing out with each breath you take
- G. Move up the body, contracting then relaxing each muscle
Correct Answer: B;D;F;C;A;G;E
Rationale: Steps: 1) Lie in a quiet place to focus; 2) Relax body to feel heavy; 3) Imagine tension flowing out with breaths; 4) Contract feet muscles; 5) Relax feet; 6) Move up body; 7) Lie still to monitor relaxation.
The nurse is caring for the middle-aged client. Which client behavior should indicate to the nurse that the client may have difficulty achieving Erikson’s developmental stage of generativity?
- A. Talks about accomplishments that made the workplace a better place
- B. Volunteers at the local nursing home reading to residents one day a week
- C. Focuses conversation on self and displays disinterest in the activities of others
- D. Shows pictures of the client’s grandchildren and the client at various sports events
Correct Answer: C
Rationale: Self-focus and disinterest in others suggest self-absorption and stagnation, indicating difficulty with generativity. Workplace accomplishments, volunteering, and involvement with grandchildren demonstrate generativity.
During a nursing home visit, the son notices multiple healing bruises on his father’s arms and legs and calls a friend who is a nurse. Which initial recommendations should the nurse provide to the son? Select all that apply.
- A. Ask your father how the bruises occurred and whether he was abused.'
- B. Contact Adult Protective Services immediately to report the abuse.'
- C. Verify with the nursing staff whether your father is on anticoagulants.'
- D. Inform the agency’s nursing supervisor that your father is being abused.'
- E. Contact the state ombudsman who can help you make an anonymous report.'
Correct Answer: A;C
Rationale: Asking about bruise causes and checking for anticoagulants (which cause bruising) are initial steps. Reporting abuse or contacting authorities requires more evidence.
The nurse is teaching an 86-year-old about glaucoma and how to administer eye drops. Which interventions should the nurse implement? Select all that apply.
- A. Plan the session at a time when a support person can attend
- B. Provide an environment that is private, quiet, and well lit
- C. Be detailed with the explanations to ensure understanding
- D. Engage as many of the client’s five senses as possible
- E. Give extensive written materials and a schedule to follow
Correct Answer: A;B;D
Rationale: A support person aids learning with vision issues, a private environment enhances focus, and engaging senses improves retention. Detailed explanations may overwhelm, and written materials should be concise.
The nurse is interviewing a family member of the hospitalized 90-year-old client to assess for common problems associated with an increased risk for falling. Which questions should the nurse ask? Select all that apply.
- A. Has your mother fallen within the past year?'
- B. Has your mother had her annual influenza vaccine?'
- C. When was the last time your mother took a pain pill?'
- D. Does your mother have any problems with urination?'
- E. Does your mother have difficulty falling asleep at night?'
Correct Answer: A;C;D;E
Rationale: Questions about past falls, pain medication, urination issues, and sleep disorders assess fall risk factors. Influenza vaccine is unrelated.