Nokea
The 34-year-old male client with an SCI is sharing with the nurse that he is worried about finding employment after being discharged from the rehabilitation unit. Which intervention should the nurse implement?
- A. Refer the client to the American Spinal Cord Injury Association (ASIA).
- B. Refer the client to the state rehabilitation commission.
- C. Ask the social worker (SW) about applying for disability.
- D. Suggest that the client talk with his significant other about this concern.
Correct Answer: B
Rationale: The state rehabilitation commission (B) provides vocational training and job placement services for individuals with disabilities like SCI. ASIA (A) focuses on research and advocacy, disability application (C) may not address employment goals, and talking with a significant other (D) is not a direct intervention.
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The nurse is caring for clients on a medical unit. Which client would be most at risk for experiencing a stroke?
- A. A 92-year-old client who is an alcoholic.
- B. A 54-year-old client diagnosed with hepatitis.
- C. A 60-year-old client who has a Greenfield filter.
- D. A 68-year-old client with chronic atrial fibrillation.
Correct Answer: D
Rationale: Atrial fibrillation (D) increases stroke risk due to clot formation. Age (A) is a factor but less specific, hepatitis (B) is unrelated, and Greenfield filters (C) prevent pulmonary embolism, not stroke.
Which environmental modifications should the nurse implement? Select all that apply.
- A. Keep the room dark and quiet.
- B. Lower the bed to the lowest position.
- C. Keep the side rails up and padded.
- D. Provide soft, soothing music.
- E. Ensure a warm, well-lit room.
- F. Make sure suction equipment is available.
Correct Answer: B,C,F
Rationale: Lowering the bed, padding side rails, and ensuring suction equipment availability reduce injury risk and manage complications during a seizure.
The nurse enters the room as the client is beginning to have a tonic-clonic seizure. What action should the nurse implement first?
- A. Note the first thing the client does in the seizure.
- B. Assess the size of the client’s pupils.
- C. Determine if the client is incontinent of urine or stool.
- D. Provide the client with privacy during the seizure.
Correct Answer: A
Rationale: Noting the first action (A) helps identify the seizure type and focus, aiding diagnosis and treatment. Pupil size (B), incontinence (C), and privacy (D) are secondary to ensuring safety and documenting the event.
The client diagnosed with a brain abscess is experiencing a tonic-clonic seizure. Which interventions should the nurse implement? Rank in order of performance.
- A. Assess the client’s mouth.
- B. Loosen restrictive clothing.
- C. Administer phenytoin IVP.
- D. Turn the client to the side.
- E. Protect the client’s head from injury.
Correct Answer: E,B,C,D,A
Rationale: 1. Protect the client’s head (E): Prevents injury during convulsions. 2. Loosen restrictive clothing (B): Ensures airway and circulation. 3. Turn to the side (D): Prevents aspiration post-seizure. 4. Administer phenytoin (C): Stops the seizure after safety is ensured. 5. Assess the mouth (A): Done post-seizure to check for injury.
The nurse is working with clients and their families regarding substance abuse. Which statement is the scientific rationale for teaching the children new coping mechanisms?
- A. The child needs to realize that the parent will be changing behaviors.
- B. The child will need to point out to the parent when the parent is not coping.
- C. Children tend to mimic behaviors of parents when faced with similar situations.
- D. Children need to feel like they are a part of the parent’s recovery.
Correct Answer: C
Rationale: Children often mimic parental behaviors (C), including unhealthy coping mechanisms. Teaching new strategies helps break this cycle. Other options misrepresent the child’s role or focus.