Nokea
The nurse is discussing management of nocturnal enuresis with the parent of a 10-year-old client who has had little response to behavioral interventions. The parent tells the nurse, 'My child wants to go to overnight camp in several months but is afraid of being teased by other children if an accident occurs.' Which of the following responses would be most appropriate for the nurse to make?
- A. The condition will be resolved by then if you are consistent with bedtime routines.
- B. We can ask your child's health care provider about trying a medication that may be helpful.
- C. You could offer to send disposable training pants for your child to wear if needed.
- D. You should consider sending your child to day camp instead of overnight camp.
Correct Answer: B
Rationale: Medications like desmopressin may help manage enuresis for events like camp, addressing the child's concerns.
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The nurse is to observe the client for shock. The client's admitting vital signs are blood pressure (BP)=116/70, pulse=86, and respirations=24. Which finding, if observed, would be most suggestive of shock?
- A. BP=140/60
- B. Pulse=100
- C. BP=114/68
- D. Pulse=60
Correct Answer: B
Rationale: Increased pulse (tachycardia) is a hallmark of shock, compensating for reduced volume. Stable or slightly varied BP and low pulse are less indicative.
The nurse is talking about diaper changes with a client who is 48 hours postpartum. The client states, 'I cannot change my baby's diaper as well as you can. Will you change it for me?' Which of the following responses would be appropriate for the nurse to make?
- A. Changing your baby's diaper now is important for the bonding process.
- B. I will stay at your bedside and watch while you change your baby's diaper.
- C. It is more important for you to take care of yourself now, so I will change your baby's diaper.
- D. It is time that you change your baby's diaper because you will have to do it by yourself after discharge.
Correct Answer: B
Rationale: Supporting the client while they change the diaper builds confidence and promotes independence.
The nurse is preparing to administer an intermittent enteral feeding to a client who has a nasogastric tube and a gastric residual volume of 75 mL. Which of the following actions should the nurse take? Select all that apply.
- A. Administer the scheduled feeding as prescribed.
- B. Discard the aspirated residual in a biohazard container.
- C. Place the client in the high-Fowler position during the feeding.
- D. Flush the nasogastric tube before and after administering the feeding.
- E. Check the pH of the residual and notify the health care provider if the pH is > 5.
Correct Answer: A,C,D
Rationale: A residual of 75 mL is typically acceptable to proceed with feeding. High-Fowler position and flushing are standard. Residual is returned, not discarded, and pH >5 is not concerning.
In the past 12-month period, a man has been arrested twice for driving while intoxicated. He is able to perform his activities of daily living without the use of alcohol and restricts his drinking to weekends. This client meets the criteria for which of the following?
- A. Alcohol withdrawal syndrome
- B. Bad judgment syndrome
- C. Substance abuse
- D. Substance dependence
Correct Answer: C
Rationale: Repeated legal issues from weekend drinking indicate substance abuse, as it causes significant impairment without daily dependence.
The nurse is reinforcing teaching for a client recently diagnosed with heart failure who is being discharged with a prescription for lisinopril. Which of the following information should the nurse include?
- A. Instruct the client to have blood specimens obtained monthly to monitor serum medication levels
- B. Review foods that high in potassium that the client should regularly include in the diet
- C. Tell the client to check the pulse for 1 minute and hold the medication if the heart rate is <60/min
- D. Tell the client to rise slowly and sit on the side of the bed for several minutes before standing up
Correct Answer: D
Rationale: Lisinopril can cause orthostatic hypotension, so slow position changes prevent dizziness and falls.