Nokea
The nurse working on a pediatric oncology unit recognizes which as a personal coping strategy for remaining effective when caring for dying children?
- A. Attending a child's memorial service
- B. Avoiding expressing personal feelings of grief or loss directly with the family
- C. Ending personal contact with the deceased's family members after they leave the hospital
- D. Increasing length of daily exercise routines
Correct Answer: D
Rationale: Increasing exercise (D) is a healthy coping strategy to manage stress. Attending memorials (A), avoiding grief expression (B), or ending contact (C) may not promote long-term emotional resilience.
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The nurse is assisting with care of a client with blunt head injury admitted for observation, including hourly neurologic checks. At 1:00 AM, the client reports a headache; the neurologic check is normal, and the nurse administers acetaminophen prn. At 2:00 AM, the client appears to be sleeping. What action does the nurse anticipate taking?
- A. Arouse the client and ask what the current month is
- B. Awaken the client and check for paresthesia
- C. Document 'relief apparently obtained' and recheck at 3:00 AM
- D. Let the client sleep but verify respiratory rate
Correct Answer: A
Rationale: Hourly neurologic checks require arousing the client to assess orientation (A). Checking paresthesia (B), assuming relief (C), or only verifying respiratory rate (D) do not meet monitoring requirements.
The nurse is caring for a client with polycythemia vera. Which of the following actions should the nurse take? Select all that apply.
- A. Encourage increased fluid intake.
- B. Prepare the client for phlebotomy.
- C. Administer low-dose aspirin as prescribed.
- D. Teach the client to elevate the legs while sitting.
- E. Request a prescription for iron supplementation.
Correct Answer: A, B, C
Rationale: Increased fluids (A), phlebotomy (B), and aspirin (C) manage polycythemia vera by reducing blood viscosity and clotting risk. Leg elevation (D) is irrelevant, and iron supplementation (E) worsens the condition.
The nurse is inserting an indwelling urinary catheter for a male client. After inserting the catheter 6 inches (15.2 cm), the nurse notes a small amount of urine in the tubing. Which of the following actions should the nurse take next?
- A. Measure the urine output.
- B. Immediately inflate the balloon.
- C. Secure the catheter tubing to the client's leg.
- D. Continue to advance the catheter to the bifurcation.
Correct Answer: D
Rationale: Advancing to the bifurcation (D) ensures proper placement in the bladder before inflating the balloon. Measuring output (A), inflating early (B), or securing (C) are premature.
A 25-year-old client is about to undergo a unilateral orchiectomy for treatment of testicular cancer. The client says to the nurse, 'I'm so worried that my future spouse is going to call off our engagement.' What is the best response by the nurse?
- A. Are you concerned about how the surgery will affect your sexuality?'
- B. If you are concerned about infertility, you could always bank your sperm.'
- C. The cancer is at an early stage. You are going to be fine.'
- D. What have you and your future spouse discussed about your condition?'
Correct Answer: D
Rationale: Asking about discussions with the spouse (D) encourages the client to share concerns and clarifies the situation. Options A, B, and C assume specific fears or provide reassurance without exploration.
The nurse has reinforced teaching with a client who has rheumatoid arthritis and is receiving methotrexate. Which of the following statements by the client would require follow-up?
- A. I will avoid drinking alcoholic beverages while taking methotrexate.'
- B. I should take precautions to prevent pregnancy while taking methotrexate.'
- C. I should avoid large crowds and people who are ill while taking methotrexate.'
- D. I will avoid consuming foods high in folic acid that will decrease the effectiveness of methotrexate.'
Correct Answer: D
Rationale: Avoiding alcohol (A), preventing pregnancy (B), and avoiding crowds (C) are correct. Avoiding folic acid (D) is incorrect, as methotrexate often requires folic acid supplementation to reduce side effects.