Nokea
The nurse is teaching a teenage female about preventing the transmission of genital herpes. Which of the following statements should the nurse include?
- A. Do not sit on toilet seats without protection.'
- B. Oral sex does not transmit the virus.'
- C. This infection can be transmitted via intercourse even when you do not feel ill.'
- D. Try to drink lots of fluids after sex to flush the reproductive tract.'
Correct Answer: C
Rationale: Genital herpes can be transmitted by oral, genital, and anal sex. The other statements are myths.
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If the nurse who was not promoted tells another friend, "I knew I'd never get the job. The hospital administrator hates me."? If she actually believes this of the administrator, who, in reality, knows little of her, she is demonstrating:
- A. compensation.
- B. reaction formation.
- C. projection.
- D. denial.
Correct Answer: C
Rationale: The nurse is demonstrating projection, attributing her own feelings of dislike onto the hospital administrator. This defense mechanism involves unconsciously adopting blaming behavior. Compensation involves emphasizing a strong point to make up for a perceived weakness, which is not the case here. Reaction formation is adopting behavior opposite to actual feelings, and denial involves ignoring an unpleasant reality, none of which are demonstrated in this scenario.
A 10-month-old child is brought to the Emergency Department because he is difficult to awaken. The nurse notes bruises on both upper arms. These findings are most consistent with
- A. wearing clothing that is too small for the child
- B. the child being shaken
- C. falling while learning to walk
- D. parents trying to awaken the child
Correct Answer: B
Rationale: The correct answer is 'the child being shaken.' Children who are shaken are frequently grasped by both upper arms, leading to bruises in that area. The presentation of a difficult-to-awaken child with bruises on the upper arms is highly concerning for non-accidental trauma, such as abusive shaking. Symptoms of brain injury associated with shaking include a decreased level of consciousness. Choices A, C, and D are less likely because the combination of a child being difficult to awaken and bruises on both upper arms is highly suggestive of non-accidental trauma rather than benign causes like ill-fitting clothing, falling while learning to walk, or parents trying to awaken the child.
When assessing a client with glaucoma, a nurse expects which of the following findings?
- A. Complaints of double vision
- B. Complaints of halos around lights
- C. Intraocular pressure of 15 mm Hg
- D. Soft globe on palpation
Correct Answer: B
Rationale: When assessing a client with glaucoma, a common finding is complaints of halos around lights. Other symptoms of glaucoma include loss of peripheral vision or blind spots, reddened sclera, firm globe, decreased accommodation, and occasional eye pain. Glaucoma may be asymptomatic until permanent damage to the optic nerve and retina occurs. Double vision is not a typical symptom of glaucoma. In terms of intraocular pressure, normal levels range from 10 to 21 mm Hg, making an intraocular pressure of 15 mm Hg within the normal range. A soft globe on palpation is not a typical finding in glaucoma.
The nurse observes bilateral bruises on the arms of an elderly client in a long-term care facility. Which of the following questions should the nurse ask this client?
- A. "How did you get those bruises?"?
- B. "Did someone grab you by your arms?"?
- C. "Do you fall often?"?
- D. "What did you bump against?"?
Correct Answer: B
Rationale: The correct answer is asking, "Did someone grab you by your arms?"? This question is direct and addresses the possibility of abuse, which is crucial when dealing with suspected abuse cases. It is important to ask direct questions in a sensitive and non-accusatory manner to gather information. Choice A is too general and may not prompt a disclosure of abuse. Choice C assumes falling as the cause without addressing abuse directly. Choice D is vague and does not specifically inquire about potential abuse, making it less effective in identifying abuse cases compared to the correct choice.
What significant event occurs in the orientation phase of a nurse-client relationship?
- A. establishment of roles
- B. identification of transference phenomenon
- C. placement of the client within their family structure
- D. client agreement that the nurse has the authority in the relationship
Correct Answer: B
Rationale: In the orientation phase of a nurse-client relationship, the significant event is the identification of transference phenomenon. Transference phenomena are intensified in relationships with authority figures like nurses and physicians. Positive transferences may include a desire for affection and dependency, while negative transferences may involve hostility and competitiveness. It is crucial to recognize and address these transferences before progress and positive changes can be made in the working stage. The other choices are incorrect; the establishment of roles may occur in the working phase, placing the client within their family structure is not a key event in the orientation phase, and client agreement on the nurse's authority is not the primary focus during this phase.