Nokea
Which of the following diagnoses require droplet precautions?
- A. Varicella
- B. Rubella
- C. Streptococcal pharyngitis
- D. Scarlet fever
- E. Shigella
- F. Hepatitis A
Correct Answer: B, C, D
Rationale: Rubella (B), streptococcal pharyngitis (C), and scarlet fever (D) are transmitted via respiratory droplets, requiring droplet precautions. Varicella (A) requires airborne precautions, while Shigella (E) and hepatitis A (F) are transmitted fecally-orally, requiring contact precautions.
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In cleansing the perineal area around the site of catheter insertion, the nurse would:
- A. Wipe the catheter toward the urinary meatus
- B. Wipe the catheter away from the urinary meatus
- C. Apply a small amount of talcum powder after drying the perineal area
- D. Gently insert the catheter another 1/2 inch after cleansing to prevent irritation from the balloon
Correct Answer: B
Rationale: Wiping away from the urinary meatus removes microorganisms from the insertion point, decreasing the risk of bladder infection. The other options increase infection risk or are inappropriate.
A client who has been diagnosed with anorexia nervosa refuses to eat lunch. The most therapeutic response by the nurse to her refusal is:
- A. Okay, missing one meal won't hurt.'
- B. You'll have to eat lunch, or we'll force-feed you.'
- C. It's not appropriate for you to try to manipulate the staff into granting your wishes.'
- D. We will not allow you to starve yourself. You may choose to eat voluntarily or be fed.'
Correct Answer: D
Rationale: Setting limits assures the client that staff has genuine concern for her safety and well-being. Giving her an actual choice will give the client an increased sense of control over her life and avoid an argument or power struggle.
A 45-year-old male client was admitted to a chemical dependency treatment center following legal problems related to alcohol abuse. He states, 'I know that alcohol is a problem for some people, but I can stop whenever I want to. I'm never sick or miss work, and no one can complain about me.' During the initial assessment, the best response by the nurse would be:
- A. The fact is you are an alcoholic or you wouldn't be here.
- B. I understand it took strength to admit yourself to the unit, and I will do my part to help you to stay alcohol-free.
- C. If you can stop drinking when you want to, why don't you stop?
- D. It's good that you can stop drinking when you want to.
Correct Answer: B
Rationale: Direct confrontation initially is nontherapeutic and may result in the client becoming frustrated and wanting to leave. A positive, supportive attitude builds trust, and identifying positive strength raises self-esteem. Offering help allows the client to feel that he is not alone in dealing with problems. Asking the client why or to give an explanation for his behavior puts him in a position of having to justify his behavior to the nurse. Giving approval or placing a value on feelings or a behavior may limit the client's freedom to behave in a way that may displease another. This response may lead to seeking praise instead of progress.
A client with human immunodeficiency syndrome has gastrointestinal symptoms, including diarrhea. The nurse should teach the client to avoid:
- A. Calcium-rich foods
- B. Canned or frozen vegetables
- C. Processed meat
- D. Raw fruits and vegetables
Correct Answer: D
Rationale: Raw fruits and vegetables can harbor pathogens, worsening diarrhea in AIDS due to immune compromise. Calcium foods, canned vegetables, and processed meats are safer.
A female client is anticipating a visit with her parents over the Thanksgiving holidays. She has recently begun experiencing periods of extreme shortness of breath, which her physician has labeled as panic attacks. Which of the following statements by the nurse would enhance therapeutic communication?
- A. Why do you feel this way?'
- B. Tell me about your dislike for your parents.'
- C. Don't worry, everything will be all right on your visit with your parents.'
- D. Perhaps you and I can discover what produces your anxiety.'
Correct Answer: D
Rationale: Asking the client to provide an explanation for her feelings is often intimidating. This response is probing and may make the client feel used and valued only for the information she can provide. This underrates the client's feelings and belittles her concerns. It may cause the client to stop sharing feelings for fear that they will be ridiculed. The emphasis is on working with the client. It shows that there is hope for change through collaboration.