Nokea
When preparing to administer to domestic violence screening tool to a female client, which statement should the RN provide?
- A. If your partner is abusing you, I need to ask these questions.
- B. State law mandates that I ask if you are a victim of domestic violence.
- C. The HCP provider needs to know if you are experiencing any domestic abuse.
- D. All clients are screened for domestic abuse because it is common in our society.
Correct Answer: D
Rationale: The correct answer is D. By stating that all clients are screened for domestic abuse because it is common in society, the nurse normalizes the screening process and reduces stigma. This approach can help the client feel more comfortable disclosing abuse. Choice A may inadvertently imply that the client's partner is abusing them, potentially leading to a defensive response. Choice B may make the client feel obligated to disclose abuse due to legal reasons, which can feel coercive. Choice C is vague and may not convey the importance of screening for domestic violence.
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The nurse administers each of the following drugs to various patients. The patient who should be most carefully assessed for fluid and electrolyte imbalance is the one receiving:
- A. Lithium (Eskalith)
- B. Clozapine (Clozaril)
- C. Diazepam (Valium)
- D. Amitriptyline
Correct Answer: A
Rationale: The correct answer is A: Lithium (Eskalith). Lithium is known to cause nephrogenic diabetes insipidus, leading to excessive urination and potential dehydration. Therefore, the patient receiving lithium should be carefully assessed for fluid and electrolyte imbalances. Clozapine (B), Diazepam (C), and Amitriptyline (D) do not have a significant impact on fluid and electrolyte balance compared to lithium.
Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, 'I don’t need to come see you anymore. I have found a therapy app on my phone that I love.' How should Carolina respond to this news?
- A. That sounds exciting, would you be willing to visit and show me the app?
- B. At this time, there is no real evidence that the app can replace our therapy.
- C. I am not sure that is a good idea right now, we are so close to progress.
- D. Why would you think that is a better option than meeting with me?
Correct Answer: A
Rationale: Rationale for Choice A: Carolina should respond positively to the patient's enthusiasm about the therapy app to maintain rapport. By asking the patient to show the app, Carolina displays genuine interest and open-mindedness, fostering a collaborative discussion. This approach allows Carolina to understand the patient's perspective and potentially integrate the app into the therapy if suitable. It also shows respect for the patient's autonomy in seeking alternative support.
Summary of other choices:
B: This response is dismissive and does not acknowledge the patient's preferences, potentially damaging the therapeutic relationship.
C: This response may come off as controlling or resistant, risking alienating the patient and hindering progress.
D: This response is confrontational and may make the patient defensive, leading to communication breakdown rather than exploration of alternatives.
The occupational health nurse is working with a female employee who was just notified that her child was involved in a MVA and taken to the hospital. The employee states, “I can’t believe this. What should I do?” Which response is best for the RN to provide in this crisis?
- A. Tell me what you think should happen.
- B. How serious was the collision?
- C. What do you think you should do?
- D. Call for transportation to the hospital.
Correct Answer: D
Rationale: The correct response is D: Call for transportation to the hospital. In this crisis situation, the most urgent need is for the employee to be with her child at the hospital. By providing transportation, the nurse ensures that the employee can reach her child quickly and offer support. This action demonstrates empathy and prioritizes the employee's immediate needs.
A: Asking the employee what she thinks should happen may not be the most appropriate response in a crisis where decisive action is needed.
B: Inquiring about the seriousness of the collision is secondary to ensuring the employee can reach her child at the hospital.
C: Asking the employee what she thinks she should do puts the onus on her to make a decision when she may be in distress and unable to think clearly.
A client who recently experienced the death of a significant other arrives at the mental health center. The client reports loss of interest in usual activities, expresses a wish to be with the deceased significant other, has been eating very little, and has not slept in several days. Which client statement is most important for the RN to explore at this time?
- A. Not sleeping for several days.
- B. Wishing to be with spouse.
- C. Lack of interest in usual activities.
- D. Eating very little.
Correct Answer: A
Rationale: The correct answer is A: Not sleeping for several days. This is the most important client statement to explore because it indicates the client may be experiencing severe sleep disturbances, which can have a significant impact on their mental and physical health. Lack of sleep can exacerbate symptoms of depression and increase the risk of self-harm or suicide. Therefore, the RN should prioritize exploring this issue to assess the client's safety and provide appropriate interventions.
Choices B, C, and D are also important concerns related to grief and depression, but the immediate risk associated with severe sleep deprivation makes option A the most critical to address first. It is essential to address all client statements eventually, but the urgency of the client's sleep disturbances requires immediate attention.
A male client with schizophrenia is demonstrating echolalia, which is becoming annoying to other clients on the unit. What intervention is best for the nurse to implement?
- A. Avoid recognizing the behavior.
- B. Isolate the client from other clients.
- C. Administer a PRN sedative.
- D. Escort the client to his room.
Correct Answer: D
Rationale: The correct answer is D: Escort the client to his room. Echolalia is a common symptom of schizophrenia, where the individual repeats words or phrases they hear. Escorting the client to his room provides a safe and appropriate environment for the client to engage in the behavior without bothering other clients. Avoiding recognition (choice A) may not address the behavior and could lead to escalation. Isolating the client (choice B) may be seen as punitive and could worsen the client's symptoms. Administering a sedative (choice C) should be a last resort and not the initial intervention for managing echolalia.