Nokea
The nurse provides information to a client who is scheduled for the implantation of an implantable cardioverter defibrillator (ICD) regarding care after implantation. The nurse tells the client that there is a need to keep a diary. What information should the nurse provide concerning the primary purpose of the diary?
- A. Analyze which activities to avoid.
- B. Document events that precipitate a countershock.
- C. Provide a count of the number of shocks delivered.
- D. Record a variety of data that are useful for the primary health care provider during medical management.
Correct Answer: D
Rationale: The primary purpose of the ICD diary is to record comprehensive data (date, time, activity, symptoms, number of shocks, and post-shock feelings) for the provider to adjust medical management, particularly medication therapy. Other options are specific aspects of this broader purpose.
You may also like to solve these questions
The nurse identifies a client's learning preference as visual. Which of the following would be appropriate when teaching the client about insulin injection?
- A. an audiotape
- B. an orange, an insulin syringe, an alcohol wipe, and a bottle of sterile saline
- C. classroom discussion
- D. an instructional pamphlet
Correct Answer: D
Rationale: For a visual learner, an instructional pamphlet with diagrams or pictures is most effective. Audiotape (A) is auditory, classroom discussion (C) is auditory/kinesthetic, and demonstration with an orange (B) is kinesthetic, making them less suitable.
The mother of a teenage client diagnosed with an anxiety disorder is concerned about her daughter's progress after discharge. She states that her daughter 'stashes food, eats all the wrong things that make her hyperactive,' and 'hangs out with the wrong crowd.' To assist the mother with preparing for her daughter's discharge, the nurse advises the mother to implement which action in order to promote optimal health?
- A. Restrict the daughter's socializing time with her school friends.
- B. Consider taking time off to help her daughter readjust to the home environment.
- C. Limit the amount of chocolate and caffeine products that are available in the home.
- D. Keep her daughter out of school until she proves that she can adjust to the school environment.
Correct Answer: C
Rationale: Limiting chocolate and caffeine reduces anxiety triggers in clients with anxiety disorders. Restricting socializing, taking time off work, or keeping her out of school are impractical or unhealthy, hindering social and emotional adjustment.
The nurse is performing an assessment on a primigravida client who has been a marathon runner for several years. The client verbalizes concern because she is no longer able to run in marathons and is concerned about the brown discoloration on her face and her increasing size. Which statements by the nurse are therapeutic?
- A. I can see you're disappointed at not being able to run.
- B. Tell me how you are feeling about the changes in your body.
- C. Don't worry. Your body will go back to normal after delivery.
- D. You need to ask your obstetrician about whether or not you can run.
- E. Wait and see. You will be back to marathon running after delivery before you know it.
- F. Some of the changes in pregnancy are permanent and that is the price that you have to pay for that bundle of joy.
Correct Answer: A,B
Rationale: The client is concerned about the body changes and life changes being experienced as a result of pregnancy. Therapeutic communication techniques include focusing on the client's feelings and concerns and acknowledging these concerns by the techniques of clarifying and encouraging discussion of feelings. Telling a client 'not to worry,' placing the client's feelings on hold, and avoiding discussion of the client's feelings are nontherapeutic communication techniques.
The nurse is monitoring a client diagnosed with type 1 diabetes mellitus. Today's blood work reveals a glycosylated hemoglobin level of 10%. The nurse creates a teaching plan based on the understanding that this result indicates which finding?
- A. A normal value that indicates that the client is managing blood glucose control well
- B. A value that does not offer information regarding the client's management of the disease
- C. A low value that indicates that the client is not managing blood glucose control very well
- D. A high value that indicates that the client is not managing blood glucose control very well
Correct Answer: D
Rationale: Glycosylated hemoglobin is a measure of glucose control during the 6 to 8 weeks before the test. It is a reliable measure for determining the degree of glucose control in diabetic clients over a period of time, and it is not influenced by dietary management 1 to 2 days before the test is done. The glycosylated hemoglobin level should be 6.0% or less for a client diagnosed with diabetes mellitus, with elevated levels indicating poor glucose control.
A client diagnosed with Parkinson's disease has begun therapy with levodopa. The nurse determines that the client understands the action of the medication if the client verbalizes that results may not be apparent for what period of time?
- A. 1 week
- B. 24 hours
- C. 5 to 7 days
- D. 2 to 3 weeks
Correct Answer: D
Rationale: Levodopa takes 2 to 3 weeks to show results in Parkinson's disease, as it gradually increases dopamine levels to alleviate symptoms. Shorter time frames (24 hours, 5 to 7 days, 1 week) are unrealistic for noticeable improvement.