Nokea
The nurse is caring for a client with cirrhosis of the liver with ascites. When instructing nursing assistants in the care of the client, the nurse should emphasize that:
- A. The client should remain on bed rest in a semi-Fowler's position.
- B. The client should alternate ambulation with bed rest with legs elevated.
- C. The client may ambulate and sit in chair as tolerated.
- D. The client may ambulate as tolerated and remain in semi-Fowlers positioning bed.
Correct Answer: D
Rationale: Semi-Fowler's position aids in breathing and reduces pressure on the abdomen.
You may also like to solve these questions
Which statements are correct for lithium?
- A. Effective for all
- B. Has a delay of 10 to 28 days in achieving therapeutic benefits
- C. Has a narrow range of safety between a therapeutic serum level and toxic levels
- D. May be therapeutic when administered in combination with any other drugs
Correct Answer: C
Rationale: Lithium has a narrow therapeutic window, requiring careful monitoring to prevent toxicity.
What is the most common cause of amblyopia?
- A. Strabismus
- B. Cataracts
- C. Astigmatism
- D. Glaucoma
Correct Answer: A
Rationale: Strabismus, or misalignment of the eyes, is the leading cause of amblyopia in children.
6. What is the rationale behind many nurses advocating complementary and alternative therapies?
- A. They promote self-care and self-determination by patients.
- B. They are congruent with a view of humans as holistic beings.
- C. They are less expensive for patients than conventional therapies.
- D. They cause few adverse effects while achieving positive outcomes.
Correct Answer: B
Rationale: Many nurses advocate CAM because it aligns with a holistic view of health, considering physical, emotional, and spiritual aspects, as stated in option B.
How should the nurse respond to Mrs. West’s statement, “Oh well, I have already lived my life anyway.”
- A. “Oh, you have nothing to worry about Mrs. West. We’re going to take good care of you.”
- B. “You feel that your life is ending, Mrs. West? Can you tell me more about your feelings?”
- C. “Your doctor is one of the best and our surgical staff is excellent.”
- D. “The x-rays indicate that your tumor is accessible and the surgery will cure your problem.”
Correct Answer: B
Rationale: Encouraging the patient to express feelings fosters trust and understanding.
What is your priority intervention for this patient?
- A. Transportation arrangements to a safe house
- B. Referral to a counselor
- C. Advise about contacting the police
- D. Follow-up appointment for injuries
Correct Answer: A
Rationale: Ensuring the patient's safety by arranging transportation to a safe house is the top priority.