Nokea
The most appropriate suggestion for the hospice nurse to give a woman whose husband died 3 months ago and her three young children would be to:
- A. Seek group counseling support for the three children.
- B. Request individual counseling and medication to manage depression.
- C. Remind her gently that bereavement care before the child's effective grieving.
- D. Continue her bereavement support through hospice.
Correct Answer: D
Rationale: Continuing bereavement support through hospice provides ongoing emotional support for the woman and her children, tailored to their needs during grief.
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For a client who excretes excessive amounts of calcium during the postoperative period after open heart surgery, which of the following measures should the nurse institute to help prevent complications associated with excessive calcium excretion?
- A. Ensure a liberal fluid intake.
- B. Provide an alkaline-ash diet.
- C. Prevent constipation.
- D. Enrich the client's diet with dairy products.
Correct Answer: A
Rationale: Liberal fluid intake promotes calcium excretion through urine, preventing complications like kidney stones or hypercalcemia.
A client with chemotherapy-induced thrombocytopenia has a platelet count of 18,000/mm³. Which nursing intervention is most important?
- A. Administer aspirin for pain.
- B. Monitor for signs of bleeding.
- C. Encourage vigorous oral hygiene.
- D. Restrict visitors.
Correct Answer: B
Rationale: A platelet count of 18,000/mm³ indicates severe thrombocytopenia, making monitoring for bleeding (e.g., petechiae, epistaxis) the most important intervention to prevent complications.
A client is admitted on the day of surgery for an arthroscopy of the left knee. Which nursing activities should be completed to avoid wrong-site surgery? Select all that apply.
- A. Ask the surgeon preoperatively to mark with a permanent marker the correct knee for the surgical site.
- B. Verbally ask the client to state his name, surgical site, and procedure.
- C. Verify the correct client with the correct operative site by medical records and radiographic diagnostic reports.
- D. Call a 'time-out' in the operating room to have the surgeon verify the correct knee before making the incision.
- E. Show the client an anatomic model of the surgery site.
Correct Answer: A,B,C,D
Rationale: To prevent wrong-site surgery, the surgeon marks the site (A), the client verifies identity and procedure (B), records are checked (C), and a time-out confirms the site (D). Showing a model (E) is educational but not a standard safety measure.
A client has sudden, severe pain in his back and chest, accompanied by shortness of breath. The client describes the pain as a 'tearing' sensation. The physician suspects the client is experiencing a dissecting aortic aneurysm. The code cart is brought into the room because one complication of a dissecting aneurysm is:
- A. Cardiac tamponade
- B. Stroke
- C. Pulmonary edema
- D. Myocardial infarction
Correct Answer: A
Rationale: A dissecting aortic aneurysm can rupture into the pericardial space, causing cardiac tamponade, a life-threatening complication requiring emergency intervention (hence the code cart). Stroke, pulmonary edema, and myocardial infarction are less common or indirect complications.
The client with a fractured femur is upset and agitated about her injury and its treatment. She says, 'How can I stay like this for weeks? I can't even move!' Which of the following is the most appropriate nursing diagnosis?
- A. Impaired physical mobility related to traction.
- B. Ineffective coping related to prolonged immobility.
- C. Deficient diversional activity related to prolonged hospitalization.
- D. Activity intolerance related to impaired mobility.
Correct Answer: B
Rationale: Ineffective coping reflects the client's emotional distress and agitation due to immobility.