Nokea
The nurse is caring for a client with a long history of alcohol and drug dependence. It would be MOST important for the nurse to include which of the following as a part of his discharge planning?
- A. Referral to a social service agency for assistance with housing.
- B. Referral to an aftercare center in the community.
- C. Participation in Alcoholics Anonymous (AA) meetings with a sponsor.
- D. A prescription for an antidepressant medication.
Correct Answer: C
Rationale: self-help groups have greatest success rate as a sustained support system in the community
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Which of the following guidelines is appropriate for the nurse to give a mother concerning the developmental stage of her seven-year-old daughter?
- A. The child's periods of shyness are to be expected.
- B. Nightmares are not characteristic of this age and should be investigated.
- C. The child should be encouraged to care for her younger sister.
- D. Punishment may be necessary for acts of independence.
Correct Answer: A
Rationale: normal for developmental stage, beginning to show independence from parents
The nurse is caring for a client with a history of gastroesophageal reflux disease (GERD).
- A. Which instruction is most appropriate for a client with GERD?
- B. Eat large meals to reduce acid production.
- C. Lie down immediately after eating.
- D. Elevate the head of the bed during sleep.
- E. Avoid drinking water with meals.
Correct Answer: C
Rationale: Elevating the head of the bed during sleep prevents acid reflux by using gravity to keep stomach contents down. Large meals and lying down post-meal worsen reflux, and water is neutral.
A client received six units of regular insulin three hours ago.
- A. Which observation would be most concerning for a client who received six units of regular insulin three hours ago?
- B. Kussmaul respirations and diaphoresis.
- C. Anorexia and lethargy.
- D. Diaphoresis and trembling.
- E. Headache and polyuria.
Correct Answer: C
Rationale: Regular insulin peaks in 2-4 hours, and diaphoresis and trembling are classic signs of hypoglycemia, a potentially life-threatening complication requiring immediate intervention (e.g., administering skim milk). Kussmaul respirations indicate hyperglycemia, while anorexia, lethargy, headache, and polyuria are not specific to hypoglycemia.
A 20-year-old woman calls the outpatient clinic to schedule her first Papanicolaou's smear. The nurse should instruct the client to
- A. avoid intercourse for 48 hours before the examination.
- B. avoid douching for 24 hours prior to her appointment.
- C. withhold all foods and fluids 12 hours before the appointment.
- D. save her first voided urine specimen the morning of her appointment.
Correct Answer: B
Rationale: douching would affect appearance of cells in vaginal smear, would make test inaccurate
A 12-year-old boy injured his right knee yesterday during a soccer game.
- A. Which medication is best for a 12-year-old boy with a painful, swollen knee and hemophilia A?
- B. Oxycodone terephthalate (Percodan).
- C. Ibuprofen (Motrin).
- D. Enteric-coated aspirin.
- E. Codeine phosphate (Paveral).
Correct Answer: D
Rationale: Codeine is an appropriate analgesic for moderate to severe pain in hemophilia A, as it does not increase bleeding risk. Oxycodone (contains aspirin), ibuprofen, and aspirin prolong bleeding time and are contraindicated in bleeding disorders.