Nokea
What are appropriate nursing strategies to assist a client in maintaining a sense of self?
- A. Addressing the client by their first name when interacting with them
- B. Treating the client with dignity
- C. Explaining procedures to the client regardless of their attentiveness
- D. Encouraging the use of personal items to foster a sense of identity
Correct Answer: B
Rationale: Maintaining a sense of self is crucial for clients in healthcare settings. Treating the client with dignity is a fundamental nursing principle that helps preserve the client's self-worth and identity. Addressing the client by their first name when interacting with them is a way to show respect, but it alone may not significantly contribute to maintaining their sense of self. Explaining procedures to the client, regardless of their attentiveness, is essential for informed consent and autonomy, empowering them in their care. Encouraging the use of personal items can foster a sense of identity as these items often hold personal significance and emotional value for the client, thus supporting their sense of self; therefore, discouraging their use would be counterproductive in maintaining a client's sense of self.
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A 12-year-old male is brought to his primary care provider to determine whether sexual abuse has occurred. The mother states, 'Because there is no permanent physical damage, he does not need any more treatment.' The nurse's response should be based on which of the following pieces of information?
- A. Male victims of sexual abuse can have long-term psychological problems.
- B. Survivors of male sexual abuse might become confused about their sexual identity.
- C. Not all male sex abuse survivors grow up to abuse other children.
- D. The needs of sexually abused children can vary based on gender and individual circumstances.
Correct Answer: B
Rationale: Male children are sexually abused nearly as often as female children. Perpetrators are usually men but can be women. Needs of male children who have been sexually abused might be different from the needs of female survivors. Male survivors might respond in anger, question their sexuality, use alcohol and other drugs, and might try to prove their masculinity by performing daring acts. Choice A is incorrect because male victims of sexual abuse can indeed have long-term psychological problems. Choice C is incorrect as not all male sex abuse survivors grow up to abuse other children. Choice D is incorrect as the needs of sexually abused children can vary based on gender and individual circumstances.
While the client is receiving quinidine, the nurse should monitor the ECG for:
- A. Peaked P wave
- B. Elevated ST segment
- C. Inverted T wave
- D. Prolonged QT interval
Correct Answer: D
Rationale: Quinidine can cause widened Q-T intervals and heart block, leading to a prolonged QT interval on the ECG. Other signs of myocardial toxicity associated with quinidine include notched P waves and widened QRS complexes. Common side effects of quinidine include diarrhea, nausea, and vomiting, while less common effects may include tinnitus, vertigo, headache, visual disturbances, and confusion. Monitoring for a prolonged QT interval is crucial due to the potential risk of serious arrhythmias. Choices A, B, and C are not typically associated with the use of quinidine and are therefore incorrect in this context.
A client with cancer is to undergo an intravenous pyelogram. The nurse should:
- A. Ensure adequate fluid intake 24 hours before the procedure
- B. Ask the client to void immediately before the study
- C. Administer medication that affects the central nervous system as prescribed
- D. Position the client appropriately for the procedure
Correct Answer: B
Rationale: The correct answer is to ask the client to void immediately before the study. For an intravenous pyelogram, the client may have orders for laxatives or enemas, so ensuring the client voids before the test is important to prevent obscuring visualization of the kidney, ureters, and bladder. Choice A is incorrect because there is no need to force fluids before the procedure. Choice C is incorrect as medications affecting the central nervous system should not be held unless specified by the healthcare provider. Choice D is incorrect as covering the reproductive organs with an x-ray shield is not necessary for an intravenous pyelogram.
Lidocaine is a medication frequently ordered for the client experiencing
- A. Atrial tachycardia
- B. Ventricular tachycardia
- C. Heart block
- D. Ventricular bradycardia
Correct Answer: B
Rationale: Lidocaine is used to treat ventricular tachycardia. This medication slowly exerts an antiarrhythmic effect by increasing the electrical stimulation threshold of the ventricles without depressing the force of ventricular contractions. It is not used for atrial arrhythmias; thus, answer A is incorrect. Answers C and D are incorrect because lidocaine does not slow the heart rate, so it is not used for heart block or bradycardia.
How should Lasix be administered to prevent hypotension?
- A. By administering it over 1-2 minutes
- B. By hanging it IV piggyback
- C. With normal saline only
- D. By administering it through a venous access device
Correct Answer: A
Rationale: Lasix should be administered over 1-2 minutes at approximately 1mL per minute to prevent hypotension. This slow administration helps to reduce the risk of adverse effects such as sudden drops in blood pressure. Choice B is incorrect because Lasix does not need to be hung IV piggyback, choice C is incorrect as Lasix administration does not require it to be mixed with normal saline only, and choice D is incorrect as Lasix does not have to be specifically administered through a venous access device (VAD) to prevent hypotension.