Nokea
Which of the following is NOT an essential minimal component of the teaching that occurs prior to getting an informed consent?
- A. The purpose of the proposed treatment or procedure
- B. The expected outcomes of the proposed treatment or procedure
- C. Who will perform the treatment or procedure
- D. When the procedure or treatment will be done
Correct Answer: D
Rationale: Essential components of informed consent include the purpose , expected outcomes , and who will perform the procedure . The specific timing is not a required minimal component.
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The nurse is caring for a client with bipolar disorder in a manic phase. Which intervention is most appropriate?
- A. Encourage group activities.
- B. Provide a quiet environment.
- C. Allow unlimited phone calls.
- D. Offer high-calorie snacks.
Correct Answer: B
Rationale: A quiet environment reduces stimuli, helping to calm a client in a manic phase.
A client with a history of chronic kidney disease is prescribed sevelamer (Renagel). The nurse should explain that this medication works by:
- A. Reducing blood pressure.
- B. Binding phosphate in the gut.
- C. Increasing urine output.
- D. Decreasing blood glucose.
Correct Answer: B
Rationale: Sevelamer binds phosphate in the gut, reducing serum phosphate levels in chronic kidney disease.
The client with borderline personality disorder spends much time around the nurse's station, making numerous minor requests. The nurse interprets these behaviors as indicating which of the following?
- A. Fears of abandonment and attention seeking
- B. Enjoyment of bothering the staff
- C. Boredom suggesting the need for something to do
- D. Lack of desire for involvement in milieu activities
Correct Answer: A
Rationale: Frequent requests and presence at the nurse's station in borderline personality disorder often reflect fears of abandonment and attention-seeking behaviors, characteristic of the disorder.
The nurse is teaching a 17-year-old girl who has a severe gonorrheal infection. The nurse realizes that the girl needs further teaching when she states:
- A. Once I'm treated, I'll have immunity.'
- B. My partner doesn't need treatment.'
- C. I won't have any more problems once I learn to protect myself.'
- D. I could have trouble getting pregnant.'
Correct Answer: A,B
Rationale: Gonorrhea does not confer immunity, and partners require treatment to prevent reinfection. Potential infertility is a correct understanding, but believing protection eliminates all problems is overly optimistic.
A client with a history of breast cancer is prescribed tamoxifen (Nolvadex). Which side effect should the nurse teach the client to report?
- A. Hot flashes
- B. Weight gain
- C. Vaginal bleeding
- D. Fatigue
Correct Answer: C
Rationale: Vaginal bleeding may indicate endometrial hyperplasia or cancer, a serious side effect of tamoxifen requiring immediate reporting.