Nokea
The nurse is talking with the parents of a 7-year-old client with newly diagnosed type 1 diabetes mellitus. Which of the following statements by the parents would indicate effective coping?
- A. Our child may not be able to participate in any sporting activities'
- B. Our whole family is willing to make sacrifices for our child's health.'
- C. We will make separate meals for our child to accommodate any dietary needs.'
- D. We are working to manage this condition so that our child can have an independent life.'
Correct Answer: D
Rationale: Aiming for the child's independence in managing diabetes indicates effective coping by focusing on empowerment. Assuming no sports or separate meals is overly restrictive, and vague sacrifices lack specificity.
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The nurse has just received the shift report. Which one of the following clients should be seen first?
- A. A 14-year-old one day post-appendectomy with a WBC of 6500
- B. A 5-year-old three days post-fracture of the right tibia with a temperature of 101° Fahrenheit
- C. An 11-month-old admitted during the previous shift with dehydration and a hematocrit of 40
- D. An 8-week-old admitted four hours earlier with sub-sternal retractions and an oxygen saturation of 90%
Correct Answer: D
Rationale: Answer D is correct. There is nothing in answer A that indicates the client is unstable. Answer B is a good choice, but the client three days post-fracture may have a slight temperature, so he should be seen second. Answer C is also a good choice, but if the infant with dehydration is stable, the 8-week-old with respiratory distress (sub-sternal retractions and low oxygen saturation) is the most critical and should be seen first.
The licensed practical nurse (LPN) is assisting the registered nurse in caring for 4 clients. Which client is at greatest risk for the development of deep venous thrombosis?
- A. 25-year-old client with abdominal pain who smokes cigarettes and takes oral contraceptives
- B. 55-year-old ambulatory client with exacerbation of chronic bronchitis and an elevated hematocrit level
- C. 72-year-old client who had coronary stent placement 2 days ago and has an elevated temperature
- D. 80-year-old client who had surgical repair of a fractured hip 4 days ago
Correct Answer: D
Rationale: An 80-year-old post-hip surgery client is at highest DVT risk due to age, immobility, and recent surgery. Smoking and contraceptives , elevated hematocrit , and stent with fever carry risks but are less immediate.
The nurse is reinforcing information about techniques to improve sleep habits with a client who experiences frequent insomnia. Which statement by the client requires further teaching?
- A. I will avoid naps later in the day.'
- B. I will keep the bedroom temperature cool.'
- C. I will read in bed before trying to go to sleep.'
- D. I will try to go to bed and wake up at the same time each day.'
Correct Answer: C
Rationale: Reading in bed associates the bed with wakefulness, requiring further teaching. Avoiding naps , cool temperature , and consistent sleep schedule promote sleep hygiene.
The nurse is discussing child safety with the parents of a 12-month-old child who is just beginning to walk. Which statement by the parents indicates a need for further instruction?
- A. Our swimming pool is fenced in with a lock on the gate.'
- B. We have installed childproof gates at the top and bottom of our stairs.'
- C. We need to lower the mattress in our child's crib.'
- D. When we are unable to supervise, we can put our child in a mobile walker.'
Correct Answer: D
Rationale: Using a mobile walker is unsafe for a walking 12-month-old due to fall and injury risks, requiring further teaching. Fenced pools , stair gates , and lowered crib mattresses are appropriate safety measures.
The nurse notes all of the following. Which should be attended to first?
- A. A blind client is calling out stating that she cannot find the call bell.
- B. There is a water spill on the floor near the bed of an elderly client who ambulates regularly.
- C. A postoperative client is asking for pain medication.
- D. A diabetic client is asking for a glass of water.
Correct Answer: B
Rationale: A water spill near an ambulatory elderly client's bed poses an immediate fall risk, requiring prompt attention to ensure safety. Call bell access, pain, or water requests are less critical.