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The nurse identifies a client's learning preference as visual. Which of the following would be appropriate when teaching the client about insulin injection?
- A. an audiotape
- B. an orange, an insulin syringe, an alcohol wipe, and a bottle of sterile saline
- C. classroom discussion
- D. an instructional pamphlet
Correct Answer: D
Rationale: For a visual learner, an instructional pamphlet with diagrams or pictures is most effective. Audiotape (A) is auditory, classroom discussion (C) is auditory/kinesthetic, and demonstration with an orange (B) is kinesthetic, making them less suitable.
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The nurse is monitoring a client diagnosed with type 1 diabetes mellitus. Today's blood work reveals a glycosylated hemoglobin level of 10%. The nurse creates a teaching plan based on the understanding that this result indicates which finding?
- A. A normal value that indicates that the client is managing blood glucose control well
- B. A value that does not offer information regarding the client's management of the disease
- C. A low value that indicates that the client is not managing blood glucose control very well
- D. A high value that indicates that the client is not managing blood glucose control very well
Correct Answer: D
Rationale: Glycosylated hemoglobin is a measure of glucose control during the 6 to 8 weeks before the test. It is a reliable measure for determining the degree of glucose control in diabetic clients over a period of time, and it is not influenced by dietary management 1 to 2 days before the test is done. The glycosylated hemoglobin level should be 6.0% or less for a client diagnosed with diabetes mellitus, with elevated levels indicating poor glucose control.
The nurse is performing an assessment on a primigravida client who has been a marathon runner for several years. The client verbalizes concern because she is no longer able to run in marathons and is concerned about the brown discoloration on her face and her increasing size. Which statements by the nurse are therapeutic?
- A. I can see you're disappointed at not being able to run.
- B. Tell me how you are feeling about the changes in your body.
- C. Don't worry. Your body will go back to normal after delivery.
- D. You need to ask your obstetrician about whether or not you can run.
- E. Wait and see. You will be back to marathon running after delivery before you know it.
- F. Some of the changes in pregnancy are permanent and that is the price that you have to pay for that bundle of joy.
Correct Answer: A,B
Rationale: The client is concerned about the body changes and life changes being experienced as a result of pregnancy. Therapeutic communication techniques include focusing on the client's feelings and concerns and acknowledging these concerns by the techniques of clarifying and encouraging discussion of feelings. Telling a client 'not to worry,' placing the client's feelings on hold, and avoiding discussion of the client's feelings are nontherapeutic communication techniques.
Which should the nurse identify as a situational crisis?
- A. Divorce
- B. Retirement
- C. Loss of a job
- D. An earthquake
- E. The birth of a child
- F. Death of a loved one
Correct Answer: A,C,F
Rationale: A situational crisis arises from an external rather than an internal source and often is unanticipated. Examples of external situations that can precipitate a situational crisis include divorce, the loss of a job, the death of a loved one, an abortion, a change in job, a change in financial status, and severe physical or mental illness. A maturational crisis occurs at a developmental stage; examples include marriage, the birth of a child, and retirement. An adventitious crisis, or crisis of disaster, is not a part of everyday life and is unplanned or accidental. This type of crisis can result from a natural disaster (flood, fire, earthquake), a national disaster (acts of terrorism, war, riots, airplane crashes), or a crime of violence (rape, assault, murder, bombing, spousal or child abuse).
The home-care nurse visits an older client diagnosed with Parkinson's disease who requires instillation of multiple eye drops. Which instruction for the administration of eye drops should the nurse plan to provide to this client who demonstrates signs/symptoms of this diagnosis?
- A. Administer the eye drops rapidly.
- B. Have a family member instill the eye drops.
- C. Lie down on a bed or sofa to instill the eye drops.
- D. Keep the eye drops in the refrigerator so that they will thicken.
Correct Answer: C
Rationale: Older adults diagnosed with Parkinson's disease will experience tremors, making it more difficult to instill eye drops. The older client is instructed to lie down on a bed or sofa to instill the eye drops to provide control and allow the drops to be administered more easily. If multiple eye drops are needed, there should be a wait time of 3 to 4 minutes between drops. It is unreasonable to expect a family member to be available consistently to instill the eye drops. Additionally, this discourages client independence. Placing the eye drops in the refrigerator should not be done unless specifically prescribed.
A client diagnosed with Parkinson's disease has begun therapy with levodopa. The nurse determines that the client understands the action of the medication if the client verbalizes that results may not be apparent for what period of time?
- A. 1 week
- B. 24 hours
- C. 5 to 7 days
- D. 2 to 3 weeks
Correct Answer: D
Rationale: Levodopa takes 2 to 3 weeks to show results in Parkinson's disease, as it gradually increases dopamine levels to alleviate symptoms. Shorter time frames (24 hours, 5 to 7 days, 1 week) are unrealistic for noticeable improvement.