Nokea
The nurse manager on the orthopedic unit is reviewing a report that indicates that in the last month five clients were diagnosed with pressure ulcers. The nurse manager should:
- A. Use benchmarking procedures to compare the findings with other nursing units in the hospital.
- B. Ask the staff education department to conduct an educational session about preventing pressure ulcers.
- C. Institute a quality improvement plan that identifies contributing factors, proposes solutions, and sets improvement outcomes.
- D. Conduct a chart audit to determine which nurses on which shifts were giving nursing care to the clients with pressure ulcers.
Correct Answer: C
Rationale: A quality improvement plan addresses root causes, proposes solutions, and sets measurable outcomes, effectively reducing pressure ulcer incidence.
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A client has entered a smoking cessation program to quit a two-pack-a-day cigarette habit. He tells the nurse that he has not smoked a cigarette for 3 weeks, but is afraid he is going to 'slip up' and smoke because of current job pressures. What would be the most appropriate reply for the nurse to make in response to the client's comments?
- A. Don't worry about it. Everybody has difficulty quitting smoking, and you should expect to as well.'
- B. If you increase your self-control, I am sure you will be able to avoid smoking.'
- C. Try taking a couple of days of vacation to relieve the stress of your job.'
- D. It is good that you can talk about your concerns. Try calling a friend when you want to smoke.'
Correct Answer: D
Rationale: This response acknowledges the client's concerns and offers a practical coping strategy (calling a friend) to manage cravings, supporting the client's efforts in smoking cessation. The other options are dismissive, overly simplistic, or impractical.
A 40-year-old female is losing most of her hair as a result of chemotherapy. Which of the following statements best explains chemotherapy-induced alopecia?
- A. The new growth of hair will be gray.
- B. The hair loss is temporary.
- C. A new hair growth will always be the same texture and color as it was before chemotherapy.
- D. The client should avoid use of wigs when possible.
Correct Answer: B
Rationale: Chemotherapy-induced alopecia is temporary, with hair typically regrowing within months after treatment ends, which is a reassuring and accurate explanation.
Regular oral hygiene is essential for the client who has had a stroke. Which of the following nursing measures is not appropriate when providing oral hygiene?
- A. Placing the client on the back with a small pillow under the head.
- B. Keeping portable suctioning equipment at the bedside.
- C. Opening the client's mouth with a padded tongue blade.
- D. Cleaning the client's mouth and teeth with a toothbrush.
Correct Answer: A
Rationale: Placing the client on their back increases the risk of aspiration, especially in stroke patients with impaired swallowing. Suction equipment, padded tongue blades, and toothbrushing are appropriate for safe oral hygiene.
A client is admitted to the surgical floor after having bowel surgery. The nurse observes that the client's urine output has decreased from 50 to 20 mL/hour. Which of the following is the most likely cause?
- A. Bowel obstruction.
- B. Adverse effect of opioid analgesics.
- C. Hemorrhage.
- D. Hypertension.
Correct Answer: B
Rationale: Opioid analgesics, commonly used post-surgery, can cause urinary retention by relaxing the bladder, reducing urine output. This is the most likely cause in this scenario.
Which instructions should the nurse include when developing a teaching plan for a client being discharged from the hospital on anticoagulant therapy after having deep vein thrombosis (DVT)? Select all that apply.
- A. Checking urine for bright blood and a dark smoky color
- B. Daily walking as a good exercise
- C. Using garlic and ginger, which may decrease bleeding time
- D. Performing foot/leg exercises and walking around the airplane cabin on long flights
- E. Prevention as the best treatment for DVT
- F. Avoiding surface bumps because the skin is prone to injury
Correct Answer: A,B,D,F
Rationale: Rationales: A) Monitoring urine for bleeding is essential on anticoagulants. B) Daily walking promotes circulation, preventing DVT recurrence. D) Foot/leg exercises and movement during flights reduce stasis. F) Avoiding bumps prevents bruising/bleeding due to anticoagulant therapy. C) Garlic and ginger may increase bleeding risk, not decrease it. E) Prevention is vague and not a specific instruction.