Nokea
The physician's role in case management includes all of the following except:
- A. participating in interdisciplinary planning for clients.
- B. serving as the expert for resource utilization.
- C. consulting with the case management team to facilitate timely orders as needed.
- D. contributing to the documentation of a client's needs for services.
Correct Answer: B
Rationale: The physician is an integral part of the case-management process in terms of assisting with defining the client's needs and the time frames for movement through the health care system; however, the physician is the expert for medical diagnosis and treatment rather than resource utilization.
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The nurse teaching an obese client about nutritional needs and weight loss should include all of the following except:
- A. knowledge of food and food products
- B. development of a positive mental attitude
- C. adequate exercise
- D. starting a fast weight-loss diet
Correct Answer: D
Rationale: Fast weight-loss diets are unsustainable and potentially harmful. Education should focus on nutrition knowledge, positive mindset, and exercise for healthy, gradual weight loss.
A nurse is instructing a patient about the warning signs of (Digitalis) side effects. Which of the following side effects should the nurse tell the patient are sometimes associated with excessive levels of Digitalis?
- A. Seizures
- B. Muscle weakness
- C. Depression
- D. Anxiety
Correct Answer: B
Rationale: Palpitations and muscle weakness are found with excessive levels of Digitalis, as they are signs of toxicity.
A client is having an abortion in a women's clinic and the nurse caring for the client does not think the reasoning is appropriate. The nurse asks, 'Are you sure you want to do this, it can't be undone. Have you read about your other options? Adoption is always a good choice.' The client states she understands all options and is comfortable with her choice. The nurse nods and leaves the room to discuss the procedure with the physician. Which client right did the nurse violate with her actions?
- A. the client's right to make personal health decisions without interference, as the nurse tried to sway the client's decision-making and healthcare choice in the direction of not having an abortion
- B. the client's right to be left alone without unsolicited attention, as the nurse inserted herself in the client's healthcare scenario and offered uninvited advice
- C. the client's right to confidentiality, as the nurse is talking to the physician about the client and the abortion
- D. the client's right to respectful care, as the nurse clearly made it known that she did not approve of the abortion
Correct Answer: A
Rationale: A client has the right to make decisions about his or her healthcare without interference from health team members. It is our duty to respect those decisions and not try to influence patients based on our beliefs.
Which of the following nursing measures is most appropriate to meet the expected outcome of positive body image?
- A. administering immune globulin intravenously
- B. assessing the extremities for edema, redness and desquamation every 8 hours
- C. explaining progression of the disease to the client and his or her family
- D. assessing heart sounds and rhythm
Correct Answer: C
Rationale: Teaching the client and family about progression of the disease includes explaining when symptoms can be expected to improve and resolve. Knowledge of the course of the disease can help them understand that no permanent disruption in physical appearance will occur that could negatively affect body image. Clients with Kawasaki disease might receive immune globulin intravenously to reduce the incidence of coronary artery lesions and aneurysms. Cardiac effects could be linked to body image, but Choice 3 is the most direct link to body image. The nurse assesses symptoms to assist in evaluation of treatment and progression of the disease.
Who is responsible for obtaining the signature from the client on the informed consent?
- A. the staff nurse
- B. the charge nurse
- C. the LPN
- D. the physician
Correct Answer: D
Rationale: It is the physician's responsibility to obtain the client's signature. The nurse is responsible for verifying that this occurred.