There are many types of torts that can be committed against clients. They include all of the following except:
- A. assault.
- B. battery.
- C. negligence.
- D. felony.
Correct Answer: D
Rationale: The correct answer is 'felony.' Felonies are serious crimes punishable by time in prison and are not considered types of torts. Types of torts include assault, battery, negligence, as well as other examples like slander, invasion of privacy, false imprisonment, and fraud. Assault involves the threat of harm, battery involves physical harm, and negligence involves a failure to exercise reasonable care. These are all civil wrongs (torts) rather than criminal offenses (felonies), making 'felony' the correct choice.
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Referral for client education in the community can be accomplished through all of the following except:
- A. community agencies such as the American Heart Association
- B. parish nurses
- C. home health care agencies
- D. unlicensed massage therapists
Correct Answer: D
Rationale: Client education should be conducted by individuals with acknowledged expertise in the subject area and appropriate credentials to support their activities within the healthcare community. Choices A, B, and C involve reputable entities or professionals who can provide accurate and reliable client education. The American Heart Association, parish nurses, and home health care agencies are recognized for their healthcare-related knowledge and qualifications. However, unlicensed massage therapists lack the necessary qualifications and expertise to deliver appropriate healthcare-related education, making them unsuitable for referrals when it comes to client education in the community.
The child with seizure disorder is being treated with Dilantin (phenytoin). Which of the following statements by the patient's mother indicates to the nurse that the patient is experiencing a side effect of Dilantin therapy?
- A. "She is very irritable lately."?
- B. "She sleeps quite a bit of the time."?
- C. "Her gums look too big for her teeth."?
- D. "She has gained about 10 pounds in the last 6 months."?
Correct Answer: C
Rationale: The correct answer is '"Her gums look too big for her teeth."?' Hyperplasia of the gums is a known side effect associated with Dilantin therapy. Option A, '"She is very irritable lately,"?' is not a typical side effect of Dilantin. Option B, '"She sleeps quite a bit of the time,"?' is a common side effect of Dilantin but not specific to gum hyperplasia. Option D, '"She has gained about 10 pounds in the last 6 months,"?' is not typically associated with Dilantin therapy and is unrelated to the question.
A client reports that someone is in the room and trying to kill him. The nurse's best response is:
- A. "No one is in your room. Let's get you more medicine."?
- B. "I do not see anyone, but you seem to be very frightened."?
- C. "No one can hurt you here."?
- D. "Just tell the person to go away."?
Correct Answer: B
Rationale: When a client reports hallucinations or delusions, it is crucial to respond in a non-confrontational and empathetic manner. Choice B acknowledges the client's fear without confirming the delusion, showing understanding, and providing reassurance. This response validates the client's feelings without reinforcing the false belief. The other responses in choices A, C, and D dismiss the client's feelings or perceptions, which can escalate the situation and harm the therapeutic relationship.
What is the purpose of a contract between a nurse and a client?
- A. Contracts specify the participation and responsibilities of both parties.
- B. Contracts indicate the feeling tone established between participants.
- C. Contracts are legally binding and prevent either party from ending the relationship prematurely.
- D. Contracts define the roles the participants take.
Correct Answer: A
Rationale: The purpose of a contract between a nurse and a client is to specify the participation and responsibilities of both parties. It outlines the expectations, contributions, and duties of each party involved in the professional relationship. This ensures clarity and mutual understanding. Choice B is incorrect as contracts do not indicate feeling tone but rather focus on the professional aspects. Choice C is incorrect because while contracts are legally binding, their primary purpose is not to prevent premature termination but to establish guidelines. Choice D is incorrect as contracts focus more on responsibilities and participation rather than specific roles.
A mother has just given birth to a baby who died soon after. The mother has been crying and states, "I can't believe this has happened to me. I did everything right during this pregnancy."? How should the nurse respond to this mother?
- A. Tell her she did nothing wrong; it was God's will.
- B. Tell her she can have another baby.
- C. Tell her that her behavior is not going to solve anything.
- D. Tell her nothing and let her mourn this loss in the manner she chooses.
Correct Answer: D
Rationale: Perinatal loss is a significant tragedy for parents, and it is crucial to provide sensitive and compassionate care. When a mother expresses her disbelief and feelings of doing everything right during the pregnancy, it is important for the nurse to acknowledge her pain and allow her to grieve in her way. Telling her that she did nothing wrong and it was God's will (Choice A) may not be comforting and can come across as dismissive of her feelings. Suggesting she can have another baby (Choice B) is insensitive and overlooks the grief she is experiencing for the current loss. Telling her that her behavior is not going to solve anything (Choice C) is invalidating her emotions and not supportive in this situation. Therefore, the best approach is to support her in her mourning process by respecting her feelings and allowing her to express her grief as she sees fit.