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The nurse is talking in the lounge with other nurses about grief and loss. The nurse understands which to be true regarding grief and loss? Select all that apply.
- A. The process of grief is detrimental to physical and emotional health.
- B. Age, gender, and culture are a few factors that influence the grieving process.
- C. The nurse must explore his own feelings about death before he may effectively help others.
- D. The nurse should discourage expression of grief and loss because it may upset other clients nearby.
- E. The nurse can help the family develop ways to relieve loneliness and depression following the death of a loved one.
Correct Answer: B, C, E
Rationale: Age, gender, and culture influence grief; nurses must process their own feelings to help others, and supporting families post-loss is key. Grief is not inherently detrimental, and expression should be encouraged.
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A client admitted with hepatic encephalopathy continues to attempt ambulation without assistance despite repeated instruction. Which intervention should the nurse take to promote safety?
- A. administer Xanax 6 mg PO
- B. apply a vest restraint device
- C. request a family member stay with the client around the clock
- D. move the client closer to the nurses' station
Correct Answer: D
Rationale: Moving the client closer to the nurses’ station allows frequent monitoring, promoting safety without restraints or sedation, which are less appropriate.
An elderly preoperative client seems very anxious but denies concerns when the nurse asks; however, the client's son confides that the client is very superstitious and believes it is bad luck that he is in room 113. Which of the following actions is the best response?
- A. Reassure the client that the room number will not affect his surgery outcome.
- B. Contact the admissions department and request that the client be reassigned to a different room.
- C. Ask the physician for medication to relax the client.
- D. Ask the son to stay with the client to reassure him.
Correct Answer: B
Rationale: Reassigning the client to a different room (B) addresses the client's anxiety by respecting his superstitious beliefs, promoting comfort. Reassurance (A), medication (C), or family presence (D) may not fully alleviate the specific concern.
A schizophrenic client has been taking haloperidol (Haldol) for 20 months and has developed moderate extrapyramidal symptoms (EPS). The nurse anticipates the physician will likely prescribe what medication for EPS?
- A. flumazenil (Anexate)
- B. donepezil (Aricept)
- C. naloxone (Narcan)
- D. benztropine (Cogentin)
Correct Answer: D
Rationale: Benztropine, an anticholinergic, treats EPS (e.g., dystonia, parkinsonism) caused by antipsychotics like haloperidol.
The nurse is caring for a client following the removal of a central line catheter when the client suddenly develops dyspnea and complains of substernal chest pain. The client is noticeably confused and fearful. Based on the client's symptoms, the nurse should suspect which complication of central line use?
- A. Myocardial infarction
- B. Air embolus
- C. Intrathoracic bleeding
- D. Vagal response
Correct Answer: B
Rationale: Sudden dyspnea, chest pain, and confusion post-central line removal suggest an air embolus, a serious complication requiring immediate intervention.
The nurse is preparing to hang a unit of blood on a client. The blood has been checked off with two RNs and the pre-infusion vitals recorded. The nurse is at the bedside monitoring the infusion. Shortly after beginning the infusion, the pump alarm sounds. The IV has infiltrated. No blood has yet reached the client. The client is a hard stick, and the nurse realizes that a line cannot be placed within the time frame to begin the infusion. Which action by the nurse is correct?
- A. return the blood and the tubing to the blood bank for storage until an IV can be placed
- B. place the blood bag and tubing in the medication refrigerator until an IV can be restarted
- C. cancel the order for blood and notify the health care provider that the client has no access
- D. wait until 30 minutes has passed while IV placement is attempted, and then waste the blood and chart it as expired
- E. return the blood to the blood bank and notify the next shift when they arrive that they need to start an IV and administer the blood
Correct Answer: C
Rationale: Since no blood reached the client and IV access cannot be re-established within the time frame, the nurse should cancel the order and notify the provider to reassess the need for transfusion.