Nokea
What significant event occurs in the orientation phase of a nurse-client relationship?
- A. establishment of roles
- B. identification of transference phenomenon
- C. placement of the client within the client's family structure
- D. client agreement that the nurse has the authority in the relationship
Correct Answer: B
Rationale: Transference phenomena are intensified in relationships with authority, such as physicians and nurses. Common positive transferences include desire for affection and gratification of dependency needs. Common negative transferences include hostility and competitiveness. These transferences must be recognized and resolved before growth and positive change can be undertaken in the working stage.
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The PN is caring for a client with diabetes insipidus. The nurse can expect the lab work to show:
- A. elevated urine osmolarity and elevated serum osmolarity.
- B. decreased urine osmolarity and decreased serum osmolarity.
- C. elevated urine osmolarity and decreased serum osmolarity.
- D. decreased urine osmolarity and elevated serum osmolarity.
Correct Answer: D
Rationale: In diabetes insipidus, the pituitary releases too much antidiuretic hormone (ADH) causing the client to produce a large amount of dilute (decreased osmolarity) urine and causing dehydration (elevated serum osmolarity). Choice 3 might be seen in a client with SIADH (syndrome of inappropriate ADH). Choices 1 and 2 generally don't occur- urine and serum osmolarity typically move in opposite directions.
A 21-year-old college student has just learned that she contracted genital herpes from her sexual partner. After completing the initial history and assessment, the nurse has data concerning areas pertinent to the disease. The data is likely to include all but which of the following?
- A. voiding patterns
- B. characteristics of lesions
- C. vaginal discharge
- D. prior history of varicella
Correct Answer: D
Rationale: The other choices are common reasons for which clients with herpes seek care.
A person using over-the-counter nasal decongestant drops who reports unrelieved and worsening nasal congestion should be instructed to:
- A. switch to a stronger dose of the medication.
- B. discontinue the medication for a few weeks.
- C. continue taking the same medication, but use it more frequently.
- D. use a combination of medications for better relief.
Correct Answer: B
Rationale: Prolonged use of decongestant drops (3 to 5 days) can lead to rebound congestion, which is relieved by discontinuing the medication for 2 to 3 weeks. Nasal congestion results from dilation of nasal blood vessels due to infection, inflammation, or allergy. With this dilation, there is a transudation of fluid into the tissue spaces, resulting in swelling of the nasal cavity. Nasal decongestants (sympathomimetic amines) stimulate the alpha-adrenergic receptors, producing vascular constriction (vasoconstriction) of the capillaries within the nasal mucosa. The result is shrinking of the nasal mucous membranes and a reduction in fluid secretion (runny nose). Decongestants can make a client jittery, nervous, or restless. These side effects decrease or disappear as the body adjusts to the drug. When nasal decongestants are used for longer than 5 days, instead of the nasal membranes constricting, vasodilation occurs, causing increased stuffy nose and nasal congestion. The nurse should emphasize the importance of limiting the use of nasal sprays and drops. As with any alpha-adrenergic drug (for example, decongestants), blood pressure and blood glucose levels can increase. These drugs are contraindicated and should only be used with extreme caution for clients with hypertension, cardiac disease, hyperthyroidism, and diabetes mellitus.
Which of the following services is not part of family consultation?
- A. assisting with vocational rehabilitation
- B. providing information about the client's illness
- C. teaching effective communication
- D. helping families solve problems
Correct Answer: A
Rationale: Family consultation does not involve vocational rehabilitation. It involves helping families deal with their feelings, focus, and find solutions. Choices 2, 3, and 4 are components of family consultation.
The nurse should consider which of the following as a possible cause for the symptoms experienced by the client in Question 28?
- A. iron deficiency
- B. folate deficiency
- C. peptic ulcer
- D. iron overload
Correct Answer: A
Rationale: Due to her symptoms of fatigue, shortness of breath, lightheadedness, her gender, and her fad dieting, the cause is most likely iron deficiency.