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The nurse is preparing a client for a magnetic resonance imaging (MRI). Which statement(s) by the client would require the nurse to notify the health care provider to cancel the procedure? (Select All that Apply.)
- A. I had a pacemaker inserted a few years ago because my heart was not beating fast enough.
- B. I have such terrible anxiety I don't know if I can remain still throughout the procedure.
- C. I have diabetes mellitus type and have been taking insulin for many years.
- D. I fell down my basement steps last year and broke my hip and had to have a hip replacement.
- E. When I was diagnosed with mitral valve prolapse they had to replace the valve with a prosthetic valve.
- F. A,D,E
- G. Pacemakers, hip replacements, and prosthetic valves are metallic implants unsafe for MRI due to magnetic interference. Anxiety and diabetes don’t require cancellation but may need management.
Correct Answer:
Rationale: Correct Answer: F (A, D, E)
Rationale: Pacemakers, hip replacements, and prosthetic valves contain metal components that can be affected by the strong magnetic fields of an MRI, risking displacement or malfunction. Therefore, these conditions necessitate cancellation of the procedure to prevent harm to the client. Anxiety, diabetes, and a history of hip fracture do not pose direct contraindications to MRI and can be managed appropriately during the procedure.
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The nurse is creating a plan of care for a client experiencing a situational crisis. Which is the most measurable and obtainable goal for the client to achieve?
- A. The client will discover a new sense of self-sufficiency in coping
- B. The client will express anger regarding the crisis event.
- C. The client will resume the pre crisis level of functioning
- D. The client will identify possible causes for the crisis
- F. C
- G. Resuming pre-crisis functioning is measurable by assessing prior abilities and progress. It’s obtainable as it focuses on restoring known skills.
Correct Answer:
Rationale: Correct Answer: C: The client will resume the pre-crisis level of functioning
Rationale:
1. Measurability: This goal is measurable as it involves assessing the client's current level of functioning and progress towards returning to their pre-crisis state.
2. Obtainability: Resuming pre-crisis functioning is attainable as it focuses on restoring known skills and abilities that the client had before the crisis.
3. Client-Centered: It is client-centered as it aims to help the client regain their previous level of functioning, which is specific and achievable.
4. Progress Monitoring: Progress towards this goal can be objectively tracked through assessments of the client's abilities and comparing them to their pre-crisis state.
Summary:
- Choice A is vague and subjective, making it difficult to measure and achieve.
- Choice B focuses on expressing emotions, which may not directly help the client in resolving the crisis.
- Choice D is more focused on understanding the causes of the crisis rather
The nurse is taking care of a client from a culture different from the nurse's culture. How might the nurse best provide culturally competent care?
- A. Validate knowledge about culture through continuing education.
- B. Know what to expect from many cultural groups.
- C. Find out as much as possible about a client's cultural values beliefs and health practices.
- D. Behave as appropriate for the nurse's culture.
- F. C
- G. Learning client-specific cultural values ensures tailored, respectful care.
Correct Answer:
Rationale: Correct Answer: C: Find out as much as possible about a client's cultural values beliefs and health practices.
Rationale: This choice is the best answer because it emphasizes the importance of individualizing care based on the client's specific cultural background. By taking the time to understand the client's cultural values, beliefs, and health practices, the nurse can provide care that is respectful, tailored, and effective. This approach demonstrates cultural competence and helps to build trust and rapport with the client.
Summary of other choices:
A: While continuing education is important, simply validating knowledge about culture through education may not necessarily lead to the individualized care needed for culturally diverse clients.
B: Knowing what to expect from many cultural groups is helpful, but it does not replace the importance of understanding the unique cultural background of each individual client.
D: Behaving as appropriate for the nurse's culture may not align with the client's cultural beliefs and practices, potentially leading to misunderstandings or ineffective care.
F: This choice is
A novice nurse is beginning work on a behavioral health unit and states to the preceptor "What if I encounter a client that is sexually aggressive? Which is the appropriate response by the preceptor?
- A. Set firm limits and boundaries for the client.
- B. Tell the client that you are going to report to the director of the unit.
- C. Walk away and have someone else take care of the client.
- D. It happens frequently so just ignore it they will stop.
- F. A
- G. Clear boundaries ensure safety and professionalism.
Correct Answer:
Rationale: Correct Answer: A: Set firm limits and boundaries for the client.
Rationale:
1. Setting firm limits and boundaries is essential in managing sexually aggressive behavior to ensure safety.
2. Establishing clear boundaries communicates expectations and consequences to the client.
3. It empowers the nurse to maintain control and handle the situation professionally.
4. Reporting to the director (choice B) should be done after setting immediate boundaries.
5. Walking away (choice C) or ignoring the behavior (choice D) can escalate the situation and compromise safety.
The nurse working in the ED of an urban hospital notifies the manager that there are several clients with mental health disorders still present in the ED that have been there over 48 hours. Which issue related to this phenomenon does the nurse discuss with the manager?
- A. Temporary detaining orders for clients.
- B. The revolving door for clients.
- C. Decision to practice boarding.
- D. The cost of holding clients in the ED for over 48 hours.
- F. C
- G. Boarding delays care due to lack of psychiatric beds.
Correct Answer:
Rationale: Correct Answer: G: Boarding delays care due to lack of psychiatric beds.
Rationale: The correct answer addresses the specific issue discussed by the nurse, which is the delay in care due to the lack of availability of psychiatric beds. Clients with mental health disorders should ideally be transferred to appropriate psychiatric facilities promptly for specialized care. However, when there is a shortage of psychiatric beds, clients end up being "boarded" in the ED for extended periods, which can lead to detrimental effects on their mental health and delay necessary treatment interventions.
Summary of Incorrect Choices:
A: Temporary detaining orders for clients - This choice does not directly address the issue of boarding clients in the ED due to the lack of psychiatric beds.
B: The revolving door for clients - This choice refers to the cycle of clients returning to the ED for mental health issues, which is not the primary concern raised by the nurse.
C: Decision to practice boarding - This choice does not highlight the negative impact of boarding on client care.
A client unable to work due to relapsing schizophrenia is receiving Social Security Benefits. Which benefit will this provide to the client experiencing serious mental illness?
- A. The client will have the ability to obtain psychiatric service regardless of setting.
- B. The client will be able to pay all of their bills as well as purchase medication.
- C. The client will be able to maintain some level of independence financially
- D. The client will have the option to only obtain inpatient treatment
- F. C
- G. Social Security provides financial support, aiding independence.
Correct Answer:
Rationale: Correct Answer: C: The client will be able to maintain some level of independence financially.
Rationale: Social Security Benefits help individuals with disabilities, such as schizophrenia, maintain financial independence by providing a source of income when they are unable to work. This financial support can help cover basic needs and expenses, reducing financial burden and promoting stability for the individual.
Summary:
A: While Social Security Benefits can help cover psychiatric services, it does not guarantee access to services regardless of the setting.
B: Social Security Benefits may provide financial assistance, but it may not cover all bills and medication costs.
D: Social Security Benefits do not limit the client to only obtaining inpatient treatment; they can access a variety of mental health services.
E, F: These choices are incomplete or redundant.
G: While Social Security Benefits support financial independence, it is not the only purpose; it also aims to provide financial stability during times of inability to work.