Nokea
The nurse is teaching unlicensed assistive personnel about caring for a client who is withdrawing from alcohol and street drugs. Which of the following communication techniques when observed by the nurse indicate the UAP has understood the instructions? The UAP talks to the client using:
- A. Matter-of-fact manner and short sentences.
- B. Cheerful tone of voice, using humor when appropriate.
- C. Loud voice and giving general comments.
- D. Clear explanations in a quiet voice.
Correct Answer: A
Rationale: A matter-of-fact manner with short sentences is effective for clients withdrawing from substances, as it minimizes confusion and agitation.
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A client with a history of depression is prescribed fluoxetine (Prozac). The nurse should instruct the client to report which of the following side effects?
- A. Insomnia.
- B. Bradycardia.
- C. Hypotension.
- D. Weight gain.
Correct Answer: A
Rationale: Fluoxetine commonly causes insomnia, which should be reported to manage treatment.
A client with a history of peptic ulcer disease is prescribed ranitidine (Zantac). The nurse should instruct the client to take the medication:
- A. With meals
- B. At bedtime
- C. Before breakfast
- D. After exercise
Correct Answer: B
Rationale: Ranitidine, an H2 receptor blocker, is most effective when taken at bedtime to reduce nighttime acid production and promote ulcer healing.
An 80-year-old client with severe kidney damage is placed on life support and dialysis. Care decisions are being made by his wife, who is showing signs of early Alzheimer's disease. The client's daughter arrives from out of town with a copy of the client's living will, which states that the client did not want to be on life support. The nurse should:
- A. Immediately inform the physician about the living will.
- B. Suggest to the daughter that she discuss her father's wishes with her mother.
- C. Prepare to remove the client from life support.
- D. Make a copy of the living will and give it to the client's wife.
Correct Answer: A
Rationale: Informing the physician about the living will ensures that the client's wishes are addressed promptly.
A client is scheduled for an intravenous pyelogram (IVP). Which of the following questions would be most important for the nurse to ask the client in preparation for the procedure?
- A. Have you ever had an IVP before?'
- B. Do you have any allergies to shellfish?'
- C. When was your last bowel movement?'
- D. Have you ever experienced urinary incontinence?'
Correct Answer: B
Rationale: Shellfish allergies may indicate a risk for contrast dye reactions, critical for IVP safety.
You have collected, aggregated and analyzed data which reflects the frequency of your staff returning medical equipment to the appropriate department because the staff members thought it was too unsafe to use. After the experts in the medical equipment inspect and test the equipment they report back to you, as the nurse manager, whether or not the equipment was indeed unsafe. This data indicates that 83% of the returns that were made by your staff were deemed safe and operable. What should you do?
- A. Counsel the staff about their need to stop wasting the resources of this department.
- B. Check the equipment yourself to determine the accuracy of this equipment department.
- C. Ignore it because everyone can make an innocent mistake.
- D. Plan an educational activity about determining what equipment to send for repairs.
Correct Answer: D
Rationale: The high rate of unnecessary returns (83% safe equipment) indicates a knowledge deficit among staff about assessing equipment safety. Planning an educational activity addresses this issue effectively.