The nurse is teaching a client about the healthy use of ego defense mechanisms. An appropriate goal for this client would be
- A. Reduce fear and protect self-esteem
- B. Minimize anxiety and delay apprehension
- C. Avoid conflict and leave unpleasant situations
- D. Increase independence and communicate more effectively
Correct Answer: A
Rationale: The correct answer is A: 'Reduce fear and protect self-esteem.' When teaching a client about the healthy use of ego defense mechanisms, the goal is to help the individual manage emotions effectively without denying reality. Using defense mechanisms in a healthy way aims to reduce fear and protect self-esteem while still addressing underlying issues. Choices B, C, and D are incorrect because they do not focus on the core principles of using defense mechanisms in a healthy manner. Minimizing anxiety and delaying apprehension, avoiding conflict and leaving unpleasant situations, and increasing independence and communicating more effectively do not directly align with the goal of utilizing ego defense mechanisms in a constructive way.
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A female client diagnosed with genital herpes simplex virus 2 (HSV 2) complains of dysuria, dyspareunia, leukorrhea, and lesions on the labia and perianal skin. A primary nursing action with the focus of comfort should be to
- A. Suggest 3 to 4 warm sitz baths per day
- B. Cleanse the genitalia twice a day with soap and water
- C. Spray warm water over genitalia after urination
- D. Apply heat or cold to lesions as desired
Correct Answer: A
Rationale: The correct answer is to suggest 3 to 4 warm sitz baths per day. Warm sitz baths can soothe the irritated genital area, reduce pain, and promote healing of the lesions associated with genital herpes. Cleansing the genitalia with soap and water or spraying warm water over the genitalia after urination may further irritate the lesions. Applying heat or cold to lesions as desired may not provide the same level of comfort and healing as warm sitz baths.
What is the aim of the Magna Carta of Public Health Workers?
- A. Develop skills and capabilities of health workers to deliver health projects/programs
- B. All of these
- C. Encourage those with proper qualifications to remain in government service
- D. Promote social and economic well-being of health workers
Correct Answer: B
Rationale: The correct answer is B - 'All of these.' The Magna Carta of Public Health Workers aims to achieve multiple objectives, including developing the skills and capabilities of health workers to deliver health projects/programs, encouraging those with proper qualifications to remain in government service, and promoting the social and economic well-being of health workers. Choice A, C, and D are all part of the comprehensive goals outlined in the Magna Carta for Public Health Workers.
A client with schizophrenia is receiving haloperidol (Haldol). The nurse should monitor the client for which of the following side effects?
- A. Tachycardia
- B. Hypotension
- C. Extrapyramidal symptoms
- D. Hyperglycemia
Correct Answer: C
Rationale: The correct answer is C: Extrapyramidal symptoms. Haloperidol is a first-generation antipsychotic that can lead to extrapyramidal symptoms such as tardive dyskinesia and akathisia. These side effects are common with the use of typical antipsychotics.
Choice A, Tachycardia, is not a common side effect of haloperidol.
Choice B, Hypotension, is also not a typical side effect associated with haloperidol use.
Choice D, Hyperglycemia, is not directly linked to haloperidol administration, as it is more commonly associated with other medications like atypical antipsychotics or certain medical conditions.
The occupational health nurse is completing a yearly self-evaluation. Which activity should the nurse document as an example of proficient performance criteria in professionalism?
- A. Contributes money to a professional society or organization
- B. Maintains chairmanship of the hospital nursing council
- C. Documents the nursing process in care management
- D. Develops policy initiatives that impact occupational health and safety
Correct Answer: B
Rationale: Maintaining chairmanship of the hospital nursing council demonstrates leadership and professionalism. This role involves overseeing and leading nursing activities at the hospital, showcasing a high level of responsibility and professionalism. Choices A, C, and D do not directly relate to demonstrating professionalism. Contributing money to a professional society, documenting the nursing process, or developing policy initiatives, while valuable activities, do not directly reflect the same level of leadership and professionalism as maintaining chairmanship.
Which individual has the highest risk of developing community-acquired pneumonia?
- A. A 40-year-old first-grade teacher who works with underprivileged children.
- B. A 75-year-old retired secretary with exercise-induced wheezing.
- C. A 60-year-old homeless person who is an alcoholic and smokes.
- D. A 35-year-old aerobics instructor who skips meals and eats only vegetables.
Correct Answer: C
Rationale: The correct answer is the 60-year-old homeless person who is an alcoholic and smokes. This individual has the highest risk of developing community-acquired pneumonia due to factors such as homelessness, alcoholism, and smoking, which weaken the immune system and make them more susceptible to respiratory infections. Choice A is incorrect as working with underprivileged children, while potentially exposing the individual to various illnesses, does not directly increase the risk of pneumonia. Choice B is less likely as exercise-induced wheezing may suggest asthma but does not directly correlate with pneumonia risk. Choice D, an aerobics instructor who eats only vegetables and skips meals, does not have the same level of risk factors for pneumonia as the homeless person in choice C.