When teaching a client with a new diagnosis of hepatitis about dietary management, which of the following statements should the nurse include?
- A. Increase your intake of high-protein foods.
- B. Decrease your intake of high-protein foods.
- C. Avoid foods that contain lactose.
- D. Increase your intake of dairy products.
Correct Answer: B
Rationale: For a client with hepatitis, it is important to decrease the intake of high-protein foods. High-protein foods can be harder for the liver to process and may exacerbate symptoms or contribute to liver damage. Recommending a diet with moderate protein intake is beneficial for managing symptoms and promoting liver health. Choice A is incorrect as increasing high-protein foods can strain the liver. Choice C is not directly related to hepatitis unless there is an intolerance present. Choice D is also incorrect because increasing dairy products may not be suitable for all individuals with hepatitis, especially if there are underlying liver conditions that could be aggravated by certain dairy components.
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The nurse is caring for a client following a TURP. The client's catheter becomes obstructed. The nurse should:
- A. Notify the physician immediately
- B. Increase the flow rate of the irrigating solution
- C. Milk the catheter to remove the obstruction
- D. Remove the catheter and replace it with a new one
Correct Answer: A
Rationale: Notifying the physician immediately for an obstructed catheter post-TURP prevents bladder distention or bleeding increasing flow risks pressure, milking may dislodge clots unsafely, and removal isn't nurse-initiated. Nurses act fast, ensuring patency, critical in urologic surgery.
A client's wife has been informed by the physician that her spouse has a permanent C2-C3 spinal injury, which has resulted in permanent quadriplegia. The wife states that she does not want the physician or nursing staff to tell the client about his injury. The client is awake, alert, and oriented when he asks his nurse to tell him what has happened. The nurse has conflicting emotions about how to handle the situation and is experiencing:
- A. autonomy.
- B. moral distress.
- C. moral doubt.
- D. moral courage.
Correct Answer: B
Rationale: The nurse's conflict between truth-telling and the wife's request is moral distress (B), feeling unable to act ethically. Autonomy (A) is patient rights. Doubt (C) is uncertainty. Courage (D) is acting despite fear. B is correct. Rationale: Moral distress arises from ethical dilemmas, common in nursing when values clash, per ethics frameworks, requiring resolution.
Which of the following statements best describes a wellness nursing diagnosis for an individual, family, or community?
- A. clinical judgment of transition to a higher level of wellness
- B. nursing judgment that in some area no pathology exists
- C. a judgment that in some area there is more wellness than illness
- D. statement of an area of family strength to use in interventions
Correct Answer: A
Rationale: A wellness nursing diagnosis best describes a clinical judgment of transitioning to a higher wellness level, focusing on enhancing health beyond mere absence of disease. Unlike pathology-based diagnoses, it identifies potential for growth like improving nutrition in a healthy client reflecting nursing's preventive role. Judging no pathology or more wellness than illness is narrower, missing the forward-looking aspect, while family strengths support interventions but aren't the diagnosis. This perspective encourages proactive care, aligning with wellness models to elevate client health.
Which of the following situation best describe an ethical dilemma?
- A. The nurse is not sure what time to give the medication
- B. The client refuses a procedure that can save his life
- C. The client asks what his diagnosis is
- D. The nurse forgot to give the medication
Correct Answer: B
Rationale: Client refusing a life-saving procedure (B) is an ethical dilemma autonomy vs. beneficence, per ethics. Timing (A) and forgetting (D) are errors, asking diagnosis (C) routine. B's conflicting principles best exemplify a dilemma, making it correct.
Critical thinking is an active organized cognitive process used to carefully examine one's thinking. It allows the nurse to
- A. Direct the assessment in a meaningful and purposeful way
- B. Review assessment with other health care providers
- C. Determination of the nursing care delivered
- D. Indentifies anticipated client responses to illness
Correct Answer: A
Rationale: Critical thinking directs assessment purposefully e.g., probing fatigue to link it to anemia ensuring data collection is focused and relevant. This active process analyzes, synthesizes, and prioritizes, enhancing care planning. Reviewing with providers follows assessment, not its direction. Determining care is planning/implementation, not assessment's role. Identifying responses fits evaluation, not initial data-gathering. Critical thinking's role in steering assessment ensures efficiency and depth, making it the key way nurses apply this cognitive skill in practice.