Nokea
The ED nurse is caring for a client whose native tongue is not English. The client speaks Korean and only understands a few words of English. The nurse understands that which response is best regarding how to communicate with this client?
- A. ask a bilingual family member to tell the client to point to where the pain is
- B. call the oncology unit and ask for the nurse who is a native Korean to come and translate
- C. show the client the equipment before using it, such as indicating that an IV line will be placed in the arm
- D. call for an official Korean interpreter on the facility's translator hotline to communicate with the client, family, and health care provider
Correct Answer: D
Rationale: Using an official interpreter ensures accurate, unbiased communication, adhering to ethical and legal standards for patient care.
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The nurse is doing a digital removal of stool for a client with a large fecal impaction resulting from opioid use when the client feels faint, and assessment of vital signs shows a marked decrease in pulse. Which of the following is the most likely reason for the change in pulse rate?
- A. Stimulation of the vagus nerve
- B. Onset of shock
- C. Internal bleeding
- D. Anxiety
Correct Answer: A
Rationale: Digital stool removal can stimulate the vagus nerve (A), causing bradycardia and faintness. Shock (B), bleeding (C), or anxiety (D) are less likely.
The nurse is teaching the mother of a child with attention deficit disorder regarding the use of Ritalin (methylphenidate). The nurse recognizes that the mother understands her teaching when she states the importance of:
- A. Offering high-calorie snacks
- B. Watching for signs of infection
- C. Observing for signs of oversedation
- D. Using a sunscreen with an SPF of 30
Correct Answer: C
Rationale: Ritalin, a stimulant, can cause side effects like insomnia or agitation, not oversedation. The mother's mention of oversedation indicates a misunderstanding, but the question implies correct teaching, so observing for side effects like overstimulation is key.
The nurse is caring for a 36-year-old female recently diagnosed with Addison's disease. The nurse recognizes further teaching is needed if the client states,
- A. I will need to limit my salt intake and use a salt substitute from now on.'
- B. I will have to take hormones for the rest of my life.'
- C. My husband is helping me pick out a medical alert bracelet to wear.'
- D. I have to watch for symptoms of adrenal failure.'
Correct Answer: A
Rationale: Addison’s disease requires increased salt intake due to aldosterone deficiency. Lifelong hormone therapy, medical alert bracelets, and monitoring for adrenal crisis are correct.
Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend?
- A. A family vacation in the Rocky Mountains
- B. Chaperoning the local boys club on a snow-skiing trip
- C. Traveling by airplane for business trips
- D. A bus trip to the Museum of Natural History
Correct Answer: D
Rationale: A bus trip to a museum is a low-exertion activity at sea level, minimizing the risk of hypoxia compared to high-altitude or strenuous activities.
The nurse is caring for the client following a laryngectomy when suddenly the client becomes nonresponsive and pale, with a BP of 90/40. The initial nurse's action should be to:
- A. Place the client in Trendelenburg position
- B. Increase the infusion of normal saline
- C. Administer atropine intravenously
- D. Move the emergency cart to the bedside
Correct Answer: B
Rationale: Hypotension and unresponsiveness suggest hypovolemia or shock, so increasing the normal saline infusion is the initial action to restore volume.