Nokea
When assessing a client, it is important for the nurse to be informed about cultural issues related to the client's background because
- A. normal patterns of behavior may be labeled as deviant, immoral, or insane
- B. the meaning of the client's behavior can be derived from conventional wisdom
- C. personal values will guide the interaction between persons from 2 cultures
- D. the nurse should rely on her knowledge of different developmental mental stages
Correct Answer: A
Rationale: Normal patterns of behavior may be labeled as deviant, immoral, or insane. Culture is an important variable in the assessment of individuals. To work effectively with clients, the nurse must be aware of a cultural distinctive qualities.
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The client on Floxin must be alerted to which of the following adverse effects?
- A. stunting of height in teens and young adults
- B. propensity of anovulatory uterine bleeding
- C. intractable diarrhea
- D. tendon rupture
Correct Answer: D
Rationale: Floxin is a quinolone antibiotic used in respiratory infections and pelvic and reproductive infections. Rarely, quinolones can cause tendon sheath rupture, usually of the Achilles. At the first indication of tendon pain, the antibiotic should be discontinued.
Which of these instructions should the nurse include when preparing a client for a radioactive iodine (I-131) uptake test and treatment for hyperthyroidism?
- A. Avoid taking aspirin for 3 days prior to the test.'
- B. You may eat a light breakfast on the morning of the test.'
- C. Expect to stay in the hospital for 24 hours after treatment.'
- D. In the initial 48 hours, avoid contact with children and pregnant women, and flush the commode twice after urination or defecation.'
Correct Answer: A
Rationale: In the initial 48 hours, avoid contact with children and pregnant women, and flush the commode twice after urination or defecation. The client's urine and saliva are radioactive for 24 hours after ingestion, and vomitus is radioactive for 6 to 8 hours.
The nurse is preparing a presentation on workplace incivility. Which incivility behaviors should the nurse plan to include in the presentation? Select all that apply.
- A. Verbal intimidation of nurses and invasion of personal space by HCPs.
- B. Personal insults, then ignoring a person as if that person is not present.
- C. Discussion between the nurse and HCPs about the client's condition.
- D. Teasing that occurs between nurses, HCPs, or other employees.
- E. Reporting the behaviors using the facility's incivility report form.
Correct Answer: A,B,D
Rationale: A: Verbal intimidation and space invasion are uncivil. B: Insults and ignoring are uncivil behaviors. D: Teasing can be disrespectful and uncivil. C and E are not behaviors but actions.
When observing 4 year-old children playing in the hospital playroom, what activity would the nurse expect to see the children participating in?
- A. Competitive board games with older children
- B. Playing with their own toys along side with other children
- C. Playing alone with hand held computer games
- D. Playing cooperatively with other preschoolers
Correct Answer: D
Rationale: Playing cooperatively with other preschoolers. Cooperative play is typical of the late preschool period.
The UAP is caring for the client who has been placed in bilateral wrist restraints. Which direction should the nurse give to the UAP?
- A. "The wrist restraint must remain on at all times but can be loosened if needed."
- B. "The client attempted to harm staff; only enter the room with another person."
- C. "Ask the client about the need for toileting and offer liquids every two hours."
- D. "Assess the client's skin condition and provide hand exercises every two hours."
Correct Answer: C
Rationale: The UAP should check toileting and hydration needs every two hours, as the restrained client cannot manage these independently. Skin assessment (D) is beyond UAP scope.