Nokea
The nurse would assess the client's correct understanding of the fertility awareness methods that enhance conception, if the client stated that:
- A. My sexual partner and I should have intercourse when my cervical mucosa is thick and cloudy.'
- B. At ovulation, my basal body temperature should rise about 0.5F.'
- C. I should douche immediately after intercourse.'
- D. My sexual partner and I should have sexual intercourse on day 14 of my cycle regardless of the length of the cycle.'
Correct Answer: B
Rationale: A slight rise in basal body temperature (about 0.5°F) after ovulation, due to progesterone, indicates correct understanding of fertility awareness.
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A 16-year-old client with a diagnosis of oppositional defiant disorder is threatening violence toward another child. In managing a potentially violent client, the nurse:
- A. Must use the least restrictive measure possible to control the behavior
- B. Should put the client in seclusion until he promises to behave appropriately
- C. Should apply full restraints until the behavior is under control
- D. Should allow other clients to observe the acting out so that they can learn from the experience
Correct Answer: A
Rationale: This answer is correct. Least restrictive measures should always be attempted before a client is placed in seclusion or restraints. The nurse should first try a calm verbal approach, suggest a quiet room, or request that the client take 'time-out' before placing the client in seclusion, giving medication as necessary, or restraining. This answer is incorrect. A calm verbal approach or requesting that a client go to his room should be attempted before restraining. This answer is incorrect. Restraints should be applied only after all other measures fail to control the behavior. (D Seniors) This answer is incorrect. Other clients should be removed from the area. It is often very anxiety producing for other clients to see a peer out of control. It could also lead to mass acting-out behaviors.
An 8-year-old child comes to the physician's office complaining of swelling and pain in the knees. His mother says, 'The swelling occurred for no reason, and it keeps getting worse.' The initial diagnosis is Lyme disease. When talking to the mother and child, questions related to which of the following would be important to include in the initial history?
- A. A decreased urinary output and flank pain
- B. A fever of over 103°F occurring over the last 2-3 weeks
- C. Rashes covering the palms of the hands and the soles of the feet
- D. Headaches, malaise, or sore throat
Correct Answer: D
Rationale: Urinary tract symptoms are not commonly associated with Lyme disease. A fever of 103°F is not characteristic of Lyme disease. The rash that is associated with Lyme disease does not appear on the palms of the hands and the soles of the feet. Classic symptoms of Lyme disease include headache, malaise, fatigue, anorexia, stiff neck, generalized lymphadenopathy, splenomegaly, conjunctivitis, sore throat, abdominal pain, and cough.
A 6-year-old girl is visiting the outpatient clinic because she has a fever and a rash. The doctor diagnoses chickenpox. Her mother asks the nurse how many baby aspirins her daughter can have for fever. The nurse should:
- A. Advise the mother not to give her aspirin
- B. Ask if the client is allergic to aspirin before giving further information
- C. Assess the function of the client's cranial nerve VIII
- D. Check the aspirin bottle label to determine milligrams per tablet
Correct Answer: A
Rationale: Aspirin taken during a viral infection has been implicated as a predisposing factor to Reye's syndrome in children and adolescents. Children and adolescents should not be given aspirin. Allergy to aspirin is not related to Reye's syndrome. Tinnitus, caused by damage to the acoustic nerve, occurs with aspirin toxicity, but this is not related to Reye's syndrome. A 6-year-old child should not be given any baby aspirin.
A client in labor admits to using alcohol throughout the pregnancy. The most recent use was the day before. Based on the client's history, the nurse should give priority to assessing the newborn for:
- A. Respiratory depression
- B. Wide-set eyes
- C. Jitteriness
- D. Low-set ears
Correct Answer: C
Rationale: Fetal alcohol exposure, especially recent use, can cause neonatal withdrawal symptoms like jitteriness. Respiratory depression is less common, and physical anomalies like wide-set eyes or low-set ears are associated with chronic exposure.
A female client has just died. Her family is requesting that all nursing staff leave the room. The family's religious leader has arrived and is ready to conduct a ceremony for the deceased in the room, requesting that only family members be present. The nurse assigned to the client should perform the appropriate nursing action, which might include:
- A. Inform the family that it is the hospital's policy not to conduct religious ceremonies in client rooms.
- B. Refuse to leave the room because the client's body is entrusted in the nurse's care until it can be brought to the morgue.
- C. Tell the family that they may conduct their ceremony in the client's room; however, the nurse must attend.
- D. Respect the client's family's wishes.
Correct Answer: D
Rationale: It is rare that a hospital has a specific policy addressing this particular issue. If the statement is true, the nurse should show evidence of the policy to the family and suggest alternatives, such as the hospital chapel. Refusal to leave the room demonstrates a lack of understanding related to the family's need to grieve in their own manner. The nurse should leave the room and allow the family privacy in their grief. The family's wish to conduct a religious ceremony in the client's room is part of the grief process. The request is based on specific cultural and religious differences dictating social customs.