Nokea
The nurse is talking with the parent of a 6-year-old client about how to share details of the client's adoption. Which of the following thought processes would be consistent with the expected cognitive development of the client?
- A. feels responsible for being placed for adoption
- B. imagines what life would be like with the biological family
- C. worries about what peers will say or think about being adopted
- D. defies adoptive parents and asks for information about birth parents
Correct Answer: B
Rationale: At age 6, children can imagine scenarios like life with biological parents, consistent with concrete operational thinking. Other options reflect older or atypical development.
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A woman who has been hospitalized for several days says she is having trouble getting to sleep. What is the best initial nursing intervention?
- A. Offer her a back rub.
- B. Ask her what she is worrying about.
- C. Give the ordered PRN sedative.
- D. Notify the physician.
Correct Answer: A
Rationale: A back rub promotes relaxation non-pharmacologically, addressing insomnia safely. Asking about worries, giving sedatives, or notifying the physician are less immediate.
What is the best way that parents of pre-schoolers can begin teaching their child about injury prevention?
- A. Set good examples themselves
- B. Protect their child from outside influences
- C. Make sure their child understands all the safety rules
- D. Discuss the consequences of not wearing protective devices
Correct Answer: A
Rationale: Set good examples themselves. The preschool years are the time for parents to begin emphasizing safety principles as well as providing protection. Setting a good example themselves is crucial because of the imitative behaviors of pre-schoolers, they are quick to notice discrepancies between what they see and what they are told.
A thyroid scan, a cardiac catheterization, a gallbladder x-ray, and an intravenous pyelogram are ordered for a client. Which test should the nurse schedule to be done first?
- A. Thyroid scan
- B. Cardiac catheterization
- C. Gallbladder x-ray
- D. Intravenous pyelogram
Correct Answer: A
Rationale: Thyroid scans use radioactive iodine, which can interfere with other tests' contrast agents or imaging. Scheduling it first prevents interaction with cardiac catheterization, gallbladder x-ray, or IVP.
The nurse has just received report on 4 clients. Which of the following reported information is the most concerning?
- A. Client on a heparin drip with an activated PTT of 60 seconds
- B. Client reporting back pain 1 hour following coronary angiography
- C. Client with a head injury and a Glasgow Coma Scale score of 14
- D. Client with incisional pain rated as 6 on a scale of 0-10, two days after coronary artery bypass graft
Correct Answer: B
Rationale: Back pain shortly after coronary angiography may indicate retroperitoneal bleeding, a life-threatening complication requiring immediate investigation. The other conditions are less acute or expected.
The nurse is talking with a 74-year-old client with previously well-controlled hypertension. The client currently has a blood pressure of 190/88 mm Hg and has had a cold with nasal congestion for the past 3 days. Which of the following questions would be most important for the nurse to ask?
- A. Have you received the influenza vaccine recently?
- B. Are you taking over-the-counter cold medications?
- C. Have you spent time with your grandchildren recently?
- D. Are you taking over-the-counter vitamin C supplements?
Correct Answer: B
Rationale: OTC cold medications (e.g., decongestants) can elevate blood pressure, explaining the sudden increase, making this the most important question.