Nokea
The nurse is educating a group of student nurses about perceived loss. The nurse knows that the students understand when one of them verbalizes which example?
- A. a single mother loses her job
- B. a student fails his college chemistry class
- C. a husband is grieving the loss of his wife of 40 years
- D. a first-time mother is disappointed that she had a boy instead of a girl
Correct Answer: D
Rationale: Perceived loss involves subjective disappointment, such as a mother's expectation of a different gender, unlike tangible losses like a job or spouse.
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The nurse in the emergency department (ED) provides care for a client who states that the client's spouse, 'Became angry and physically abusive.' Which action does the nurse take first?
- A. Encourage the client to verbalize feelings.
- B. Assess the client for physical trauma.
- C. Provide a list of shelters appropriate for the situation.
- D. Assist the client to identify a support system.
Correct Answer: B
Rationale: Assessing for physical trauma is the priority to identify injuries requiring immediate medical attention, ensuring the client's safety. Verbalizing feelings, providing shelter lists, and identifying support systems are important but secondary to physical assessment.
A client with the diagnosis of acute pyelonephritis who is very shy and modest is scheduled for a voiding cystourethrogram. Why should the nurse determine that this client would benefit from increased support and teaching about the procedure?
- A. Radioactive material is inserted into the bladder.
- B. Radiopaque contrast is injected into the bloodstream.
- C. The client must void while the voiding process is filmed.
- D. The client must lie on an x-ray table in a cold, barren room.
Correct Answer: C
Rationale: Having to void in the presence of others can be very embarrassing for clients, and it may actually interfere with the client's ability to void. The nurse teaches the client about the procedure to try to minimize stress from a lack of preparation and gives the client encouragement and emotional support. Screens may be used in the radiology department to try to provide an element of privacy during this procedure. The remaining options are incorrect and do not address the subject of support.
The nurse is developed a teaching plan for a client prescribed spironolactone. On which psychosocial side effect of the medication should the nurse base the teaching plan?
- A. Edema
- B. Hair loss
- C. Weight loss
- D. Decreased libido
Correct Answer: D
Rationale: The nurse should be aware of the fact that the client taking spironolactone, a potassium-sparing diuretic, may experience body image changes that result from a threatened sexual identity. These are related to decreased libido, gynecomastia in males, and hirsutism in females. Edema, weight loss, and hair loss are not specifically associated with the use of this medication.
A client has a hip fracture repair with a prosthetic implant placed. On the day after the implant, the nurse finds the client surrounded by papers from his briefcase and planning a phone meeting. The nurse plans to discuss activities with the client and should base the discussion on which information?
- A. Rest is an essential component of bone healing.
- B. Setting limits on a client's behavior is a mandated nursing role.
- C. Not keeping up with his job will increase the client's stress level.
- D. Involvement in his job will keep the client from becoming bored.
Correct Answer: A
Rationale: Rest is an essential component of bone healing, particularly after a hip fracture repair with a prosthetic implant. Engaging in work-related activities, such as planning a phone meeting, may interfere with the necessary rest and recovery process. Options 2, 3, and 4 do not prioritize the physiological need for rest and healing, which is critical at this stage of recovery.
A client diagnosed with a recent complete T4 spinal cord transection tells the nurse that he will walk again as soon as the spinal shock resolves. Which statement provides the most accurate basis for planning a response to the client?
- A. The client is projecting by insisting that walking is the rehabilitation goal.
- B. To speed acceptance, the client needs reinforcement that he will not walk again.
- C. Denial can be protective while the client deals with the anxiety created by the new disability.
- D. The client needs to move through the grieving process rapidly to benefit from rehabilitation.
Correct Answer: C
Rationale: During the adjustment period that occurs the first few weeks after a spinal cord injury, clients may use denial as a defense mechanism. Denial may decrease anxiety temporarily, and it is a normal part of grieving. After the spinal shock resolves, the prolonged or excessive use of denial may impair rehabilitation. However, rehabilitation programs include psychological counseling to deal with denial and grief.