Which of the following nursing intervention would least likely be effective when dealing with a client with aggressive behavior?
- A. Approach him in a calm manner
- B. Provide opportunities to express feelings
- C. Maintain eye contact with the client
- D. Isolate the client from others
Correct Answer: C
Rationale: Maintaining eye contact (C) is least effective with aggressive clients; it can escalate tension, per de-escalation guidelines. Calm approach (A), expression (B), and isolation (D) soothe or manage behavior. Eye contact may provoke, making C incorrect.
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A client with hypertension is being taught about the DASH diet. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should increase my intake of sodium-rich foods.
- B. I should decrease my intake of potassium-rich foods.
- C. I should increase my intake of fruits and vegetables.
- D. I should decrease my intake of whole grains.
Correct Answer: C
Rationale: The correct answer is C. The Dietary Approaches to Stop Hypertension (DASH) diet is recommended for managing hypertension. Increasing the intake of fruits and vegetables is a key component of the DASH diet as these foods are rich in nutrients that can help lower blood pressure levels. Choices A, B, and D are incorrect because they go against the principles of the DASH diet, which focuses on reducing sodium intake, increasing potassium-rich foods, and consuming whole grains.
The nurse is caring for clients in a rural health clinic and wants to promote illness prevention. Which action should the nurse take?
- A. Provide education about accident prevention
- B. Screen all clients for hypertension
- C. Refer clients with chronic conditions to a specialist
- D. Teach clients with diabetes about a diabetic diet
Correct Answer: A
Rationale: In a rural clinic, illness prevention primary prevention aims to stop disease before it starts, critical where access lags. Providing accident prevention education, like safe tractor use or fall risks, targets common rural hazards, reducing injuries proactively. Screening for hypertension is secondary, detecting issues, not preventing them. Referring chronic cases to specialists or teaching diabetic diets is tertiary, managing existing conditions, not averting onset. Accident prevention fits rural needs data shows higher injury rates in such areas empowering clients with knowledge to avoid harm. The nurse's action aligns with nursing's preventive role, addressing environmental and lifestyle risks unique to the setting, enhancing community health by tackling root causes before they escalate, a practical step given limited rural resources.
All of the following characteristics would indicate to the nurse that an elder client might experience undesirable effects of medicines except:
- A. Increased oxidative enzyme levels
- B. Alcohol taken with medication
- C. Medications containing magnesium
- D. Decreased serum albumin
Correct Answer: A
Rationale: Oxidative enzyme levels decrease with age, not increase, affecting drug metabolism.
Caring is healing, it is communicated through the consciousness of the nurse to the individual being cared for. It allows access to higher human spirit.
- A. Benner
- B. Watson
- C. Leininger
- D. Swanson
Correct Answer: B
Rationale: Jean Watson's Human Caring Theory, developed in the 1970s, defines caring as a healing force transmitted through the nurse's consciousness, connecting to the patient's spirit. She sees nursing as transcending physical acts, fostering openness to a higher human essence. Unlike Benner's skill progression, Leininger's cultural focus, or Swanson's process model, Watson's approach is deeply philosophical, emphasizing transpersonal caring moments like a nurse's empathy soothing a dying patient's fear. Her 10 Carative Factors (e.g., instilling hope) guide this spiritual exchange, influencing holistic nursing practices globally, particularly in palliative care, where emotional and existential support is paramount.
During a teaching session on dietary management for heart failure, a client makes a statement. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should increase my intake of foods high in sodium.
- B. I should increase my intake of foods high in potassium.
- C. I should decrease my intake of fluids.
- D. I should decrease my intake of fiber.
Correct Answer: C
Rationale: The correct answer is C because decreasing fluid intake is essential in managing fluid retention and symptoms of heart failure. Restricting fluids helps prevent excessive fluid buildup in the body, thus reducing the workload on the heart and alleviating symptoms like swelling and shortness of breath. Choices A, B, and D are incorrect. Increasing intake of foods high in sodium can exacerbate fluid retention and worsen heart failure symptoms. Increasing potassium-rich foods is beneficial for some heart conditions but not heart failure specifically. Decreasing fiber intake is not a standard recommendation for heart failure management.