Nokea
The nurse is performing discharge teaching for Mrs. S after cardiac angioplasty. Her husband is present for the teaching. While explaining the prescription for antiplatelet medication to use at home, Mrs. S's husband states, 'I don't think I can afford to refill that medication.' What is the most appropriate response of the nurse?
- A. Don't worry, your insurance will cover it.
- B. I'll ask the physician if he can prescribe a medication that is more affordable.
- C. You should apply for Medicare to see if they can help you.
- D. This medication is essential for her care and should be given priority over all others that she is taking.
Correct Answer: B
Rationale: The most appropriate response of the nurse is option B: "I'll ask the physician if he can prescribe a medication that is more affordable." This response demonstrates empathy towards the husband's concerns about affordability and shows willingness to explore alternative solutions. It acknowledges the financial constraint without making assumptions about insurance coverage or suggesting a specific program like Medicare. It also shows collaboration by involving the physician in finding a suitable alternative medication. The other choices are incorrect because they do not directly address the husband's affordability concern or offer a proactive solution to the issue.
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A nurse is using active listening as a form of therapeutic communication when:
- A. She uses humor to put the client at ease in a situation
- B. She restates what the client said in slightly different words
- C. She uses eye contact and maintains an open stance while the client is talking
- D. She provides personal information to show the client she can relate to him
Correct Answer: C
Rationale: The correct answer is C because using eye contact and maintaining an open stance while the client is talking demonstrates active listening. Eye contact shows attentiveness and respect, while an open stance conveys empathy and receptiveness. This non-verbal communication encourages the client to feel heard and understood, fostering a therapeutic relationship.
Choice A is incorrect because using humor may not always align with the client's feelings or be perceived as appropriate. Choice B is incorrect as restating what the client said is a form of paraphrasing, not active listening. Choice D is incorrect because providing personal information can shift the focus away from the client's needs and may breach professional boundaries.
Which of the following is an example of the intervention phase of the individualized nursing care plan for a client who receives a colostomy after a bowel resection?
- A. Taking a health history and performing a physical exam prior to the procedure
- B. Instructing the client about how to care for his colostomy stoma
- C. Developing goals that state the client will ambulate three times a day
- D. Determining that the client may need more support at home after dismissal
Correct Answer: B
Rationale: The correct answer is B. Instructing the client about how to care for his colostomy stoma is an example of the intervention phase as it involves providing specific guidance to the client on post-operative care. This intervention directly addresses the client's needs post-colostomy and helps promote optimal healing and adjustment.
Choice A is part of the assessment phase, which occurs before the intervention phase. Choice C involves goal-setting, which is part of the planning phase. Choice D pertains to discharge planning, which is part of the evaluation phase.
In summary, Choice B is the correct answer because it aligns with the intervention phase of the nursing care plan, focusing on providing necessary education and support to the client regarding colostomy care.
A woman presents with bruises on her face and back in various stages of healing. She states, 'sometimes he just gets so angry.' Which of the following statements is most appropriate as a response from the nurse?
- A. Do you mean your boyfriend?
- B. Do you mean your boyfriend?
- C. No one will ever hurt you again.
- D. Tell me more about what happens when he gets angry.
Correct Answer: D
Rationale: The correct answer is D: "Tell me more about what happens when he gets angry." This response is appropriate because it encourages the woman to share more information about the situation, allowing the nurse to assess the potential abuse and provide appropriate support. Choice A and B are identical and do not prompt further discussion. Choice C is dismissive and unrealistic. Asking for more details, as in choice D, helps gather crucial information for intervention.
Which of the following clients is most likely ready to be dismissed from an inpatient care setting to home?
- A. A 65-year old male with urine output of 60cc in the past four hours
- B. A 2-month old female with a temperature of 100.6 rectally
- C. A 38-year old female who transitioned from IV TPN to full liquids six hours ago
- D. A 4-year old male with an oxygen saturation of 96% on room air
Correct Answer: D
Rationale: The correct answer is D because an oxygen saturation of 96% on room air indicates adequate oxygenation, suggesting the client is stable and can be discharged home. A: Low urine output may indicate dehydration or kidney issues, requiring further monitoring. B: A fever in an infant warrants evaluation for infection, not ready for discharge. C: Recent transition from IV TPN to full liquids may require ongoing monitoring for tolerance and nutritional status.
A nursing unit is implementing a new electronic charting program for the nursing staff to use. Which of the following best describes a disadvantage of using electronic charting?
- A. The information is more likely to be lost or used inappropriately.
- B. Any provider in the unit can have access to the client's medical records.
- C. The system diminishes communication between nurses and providers.
- D. The program may be confusing and difficult to implement.
Correct Answer: D
Rationale: The correct answer is D: The program may be confusing and difficult to implement. Implementing a new electronic charting program may be challenging due to the complexity of the software and the learning curve for staff. It can take time and resources to train employees on how to effectively use the program, leading to potential confusion and resistance to change. This disadvantage could result in delays in charting, errors, and frustrations among staff members.
Other choices are incorrect because:
A: The information is more likely to be lost or used inappropriately - Electronic charting systems often have built-in security measures to prevent data loss and unauthorized access.
B: Any provider in the unit can have access to the client's medical records - Electronic charting systems have role-based access control to limit who can view specific patient information.
C: The system diminishes communication between nurses and providers - Electronic charting can actually improve communication by allowing real-time access to patient information.