Nokea
The team leader is reviewing the pain management plan for Mr. U. He is having significant pain related to the cancer and the pulmonary resection. Which option would be the best for Mr. U?
- A. Mr. U is instructed to ask for pain medication whenever he needs it.
- B. Mr. U is to receive around-the-clock fixed doses of opioid analgesics.
- C. Mr. U should be offered the nonopioid medication first to see it if works.
- D. Mr. U has a high risk for respiratory distress, so opioids are not prescribed.
Correct Answer: B
Rationale: The correct answer is B because Mr. U is experiencing significant pain related to cancer and pulmonary resection, which typically requires continuous pain management. Around-the-clock fixed doses of opioid analgesics provide consistent pain relief and can be adjusted based on his pain levels. This approach ensures adequate pain control without the need for Mr. U to wait until the pain becomes severe before asking for medication. Option A may lead to undertreatment of pain. Option C delays effective pain relief for Mr. U who is already experiencing significant pain. Option D is incorrect as opioids can be safely administered with proper monitoring, even in patients at high risk for respiratory distress.
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The nursing staff are making suggestions about how to help Ms. C (bowel resection) overcome her reluctance to perform colostomy care. Which suggestion will the team leader try first?
- A. Verbally reexplain the procedure and give her written material.
- B. Have a family member come in and do it for her.
- C. Continue to do it for her until she is ready.
- D. Ask her to hold the clamp while the bag is being emptied.
Correct Answer: A
Rationale: The correct answer is A because it involves providing Ms. C with information and resources to help her understand and feel more comfortable with the colostomy care procedure. Verbally reexplaining the procedure and providing written material will empower her with knowledge and autonomy. Choice B undermines her independence and may not address her reluctance. Choice C promotes dependency rather than encouraging her to take ownership of her care. Choice D involves a hands-on approach that may not address her underlying concerns or fears about the procedure. Overall, choice A is the most appropriate initial step to support Ms. C in overcoming her reluctance.
The community health nurse is listening to a client talk about a personal problem. Which of these actions by the nurse is most appropriate?
- A. The nurse should increase the physical distance from the client.
- B. The nurse should lean toward the client and make eye contact.
- C. The nurse should periodically interrupt the client to ask questions.
- D. The nurse should initiate the physical assessment to distract the client.
Correct Answer: B
Rationale: The correct answer is B because leaning towards the client and making eye contact shows active listening and empathy. This helps the client feel heard and supported. Increasing physical distance (A) may create a barrier. Interrupting the client (C) can be perceived as disrespectful. Initiating a physical assessment (D) is inappropriate as it may seem insensitive and dismissive of the client's concerns.
Which statement, if made by the nurse, could positively affect the course of the patient's situation by suggestibility?
- A. "Breastfeeding will provide time to bond with your baby.=
- B. "Breastfeeding will take longer than giving your baby a bottle.=
- C. "You will need to be careful about taking medications while breastfeeding.=
- D. "Breastfeeding mothers can develop infections that are serious.=
Correct Answer: A
Rationale: The correct answer is A because it emphasizes the positive aspect of breastfeeding, which can influence the patient's perception and behavior positively. By highlighting the bonding experience, the nurse can encourage the patient to view breastfeeding as a rewarding and meaningful activity, potentially increasing the likelihood of successful breastfeeding. Option B focuses on the time aspect and may discourage the patient. Option C introduces a potential negative aspect, which could create fear or uncertainty. Option D mentions a risk of infection, which could lead to anxiety or hesitation. In summary, choice A promotes a positive outlook and emotional connection, making it the most effective in positively affecting the patient's situation.
Which facial feature, if displayed by the nurse, best conveys warmth?
- A. Small pupils and a fixed gaze
- B. Furrowed brow and a wrinkled forehead
- C. Pursed lips and a forced smile
- D. Relaxed muscles and a concerned expression
Correct Answer: D
Rationale: The correct answer is D because relaxed muscles and a concerned expression convey warmth. Relaxed muscles suggest a sense of ease and approachability, while a concerned expression shows empathy and care. Small pupils and a fixed gaze (A) can indicate tension or distance. Furrowed brow and a wrinkled forehead (B) often signify stress or frustration. Pursed lips and a forced smile (C) may come across as insincere. Overall, D best conveys warmth through a combination of physical relaxation and emotional concern.
The nurse cares for an elderly patient in a long-term care center. Which would be inappropriate for the nurse to share with the client?
- A. Reminisce about birthday celebrations and inquire about the client's traditions.
- B. Use high levels of intimacy to help the client feel more comfortable with the nurse.
- C. Establish a helping relationship based on trust by sharing a personal story with the client.
- D. Share with the client how meditation decreased nausea during chemotherapy treatment.
Correct Answer: B
Rationale: The correct answer is B because using high levels of intimacy with a client, especially in a professional setting like a long-term care center, can violate boundaries and be inappropriate. The nurse should maintain a professional and therapeutic relationship with the client. Reminiscing about birthday celebrations (A) can help establish rapport and show interest in the client's life. Sharing personal stories (C) can build trust and connection. Sharing a relevant experience about meditation (D) can provide valuable information and support. In summary, maintaining appropriate boundaries and professionalism is crucial in a nurse-client relationship.