Nokea
Which nursing goal is the highest priority at this time?
- A. To improve the client's distorted body image
- B. To help the client use healthier coping techniques
- C. To restore normal nutrition and health
- D. To help the client develop assertiveness
Correct Answer: C
Rationale: Restoring nutrition is critical to address life-threatening malnutrition.
You may also like to solve these questions
After conferring with the nurse, which response by the receptionist to the mother is most appropriate at this time?
- A. The clinic cannot release that information.
- B. Your daughter will return the phone call shortly.
- C. You may talk to your daughter after her examination.
- D. Your daughter came to the clinic for birth control.
Correct Answer: A
Rationale: Confidentiality protects the teen's privacy, especially for reproductive health.
When the client calls the nurse to report the following physical changes, which symptom is considered a serious side effect of clozapine that needs to be reported immediately to the prescribing physician?
- A. Frequent diarrhea
- B. Severe sore throat
- C. Gradual weight loss
- D. Ringing of the ears
Correct Answer: B
Rationale: Severe sore throat may indicate agranulocytosis, a life-threatening side effect of clozapine.
Which outcome would the nurse expect providing honest explanations, including discussion about unpleasant experiences, to produce in a seriously ill school-age child?
- A. Confidence in caregivers
- B. Less anxiety about treatments
- C. Willingness to talk about feelings
- D. None of the above
Correct Answer: A
Rationale: Honesty builds trust and confidence in caregivers.
Which nursing instruction is most appropriate when teaching a client who self-administers haloperidol (Haldol)?
- A. Take the pills on an empty stomach.
- B. Do not skip meals while taking the drug.
- C. Stop taking the drug if sedation occurs.
- D. Rise slowly from a sitting position.
Correct Answer: D
Rationale: Rising slowly prevents orthostatic hypotension, a common side effect.
If the adolescent who is involved in gang activities demonstrates the following behaviors during group meetings, which is most indicative of resistance to therapy?
- A. The adolescent borrows cigarettes from others.
- B. The adolescent laughs inappropriately.
- C. The adolescent keeps checking the clock.
- D. The adolescent fidgets in the chair.
Correct Answer: B
Rationale: Inappropriate laughter suggests discomfort or dismissal of the therapeutic process.