Nokea
The nurse is teaching a newly diagnosed client about Crohn's disease. The nurse understands which barriers may prevent effective client learning? Select all that apply.
- A. language barriers
- B. motivation to learn
- C. lack of a support system
- D. adequate financial resources
- E. cognitive dysfunction, such as schizophrenia
Correct Answer: A,B,C,E
Rationale: Language barriers, low motivation, lack of support, and cognitive dysfunction hinder learning. Adequate finances are not a barrier.
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To promote self-care, the nurse is planning to teach a client in skeletal leg traction about measures to increase bed mobility. Which item is most helpful for this client for achievement of this goal?
- A. Fracture bedpan
- B. Overhead trapeze
- C. Isometric exercises
- D. Range-of-motion exercises
Correct Answer: B
Rationale: The use of an overhead trapeze is extremely helpful for assisting a client with moving about in bed and getting on and off the bedpan. This device has the greatest value for increasing overall bed mobility. A fracture bedpan is useful for reducing discomfort with elimination. Isometric exercises will not increase bed mobility and could be harmful for a client in skeletal traction. Range-of-motion exercises can also be harmful to a client in skeletal traction and should not be initiated unless there are specific prescriptions to do so.
The nurse has taught the client with pleurisy about measures to promote comfort during recuperation. The nurse determines that the client has understood the information if the client states the need to follow which instruction?
- A. Try to take only small, shallow breaths.
- B. Take as much pain medication as possible.
- C. Lie on the affected side as much as possible.
- D. Splint the chest wall during coughing and deep breathing.
Correct Answer: D
Rationale: The client with pleurisy should splint the chest wall during coughing and deep breathing. Taking small, shallow breaths promotes atelectasis. The client should take medication cautiously so that adequate coughing and deep breathing are performed and an adequate level of comfort is maintained. The client may also lie on the affected side to minimize the movement of the affected chest wall.
Cyclophosphamide is prescribed for the client diagnosed with breast cancer, and the nurse provides instructions to the client regarding the medication. Which statement by the client indicates the need for further teaching?
- A. If I lose my hair, it will grow back.
- B. If I develop a sore throat, I should notify the doctor.
- C. I need to limit my fluid intake while taking this medication.
- D. I need to avoid contact with anyone who recently received a live virus vaccine.
Correct Answer: C
Rationale: Cyclophosphamide can cause hemorrhagic cystitis, requiring copious fluid intake (2–3 liters/day) to prevent it, not fluid restriction. Hair regrowth, reporting sore throat (indicating infection), and avoiding live virus vaccine contacts are correct due to immunosuppression.
The nurse teaches a client at risk for coronary artery disease about lifestyle changes needed to reduce his risks. The nurse determines that the client understands these necessary lifestyle changes if the client makes which statements?
- A. I will attempt to stop smoking.
- B. I will be sure to include some exercise such as walking in my daily activities.
- C. I will work at losing some weight so that my weight is at normal range for my age.
- D. I will limit my sodium intake every day and avoid eating high-sodium foods such as hot dogs.
- E. It is acceptable to eat red meat and cheese every day as I have been doing, as long as I cut down on the butter.
- F. I will schedule regular doctor appointments for physical examinations and monitoring my blood pressure.
Correct Answer: B,C,D,F
Rationale: Coronary artery disease affects the arteries that provide blood, oxygen, and nutrients to the myocardium. Modifiable risk factors include elevated serum cholesterol levels, cigarette smoking, hypertension, impaired glucose tolerance, obesity, physical inactivity, and stress. The client is instructed to stop smoking (not cut down), and the nurse should provide the client with resources to do so. The client is also instructed to maintain a normal weight and include physical activity in the daily schedule. The client needs to limit sodium intake and foods high in cholesterol, including red meat and cheese. The client must follow up with regular primary health care provider appointments for physical examinations and monitoring blood pressure.
A mother brings her 6-month-old baby to the nurse practitioner for a routine well-baby check. Which behavior reported by the mother is concerning to the nurse?
- A. looks at self in a mirror
- B. brings things to mouth
- C. does not laugh or make squealing sounds
- D. begins to sit without support
Correct Answer: C
Rationale: Lack of laughing or squealing at 6 months suggests a developmental delay, as these are expected social behaviors. Other behaviors are age-appropriate.