Nokea
Which of the following nursing interventions will be most effective when caring for a client who is experiencing powerlessness?
- A. Make certain that all staff members focus only on the client's capabilities.
- B. Encourage family members to become more responsible for the client's care.
- C. Request a referral to a psychologist.
- D. Include the client in decision making whenever possible.
Correct Answer: D
Rationale: Including the client in decision-making empowers them, reducing feelings of powerlessness by restoring a sense of control.
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A 48-year-old client with cancer has been receiving 10 mg of I.V. morphine while hospitalized. In control, the nurse should administer which of the following doses of oral morphine?
- A. 25 mg.
- B. 30 mg.
- C. 40 mg.
- D. 10 mg.
Correct Answer: B
Rationale: The equianalgesic conversion from 10 mg I.V. morphine to oral morphine (1:3 ratio) is 30 mg, as oral morphine has lower bioavailability due to first-pass metabolism.
A client's job involves working in a warm, dry room, frequently bending and crouching to check the underside of a high-speed press, and wearing eye guards. Given this information, the nurse should assess the client for which of the following?
- A. Muscle aches.
- B. Thirst.
- C. Lethargy.
- D. Orthostatic hypotension.
Correct Answer: D
Rationale: Frequent bending and crouching in a warm, dry environment increases the risk of orthostatic hypotension due to dehydration and positional changes.
The physician prescribes metoclopramide hydrochloride (Reglan) for the client with hiatal hernia. The nurse plans to instruct the client that this drug is used in hiatal hernia therapy to accomplish which of the following objectives?
- A. Increase tone of the esophageal sphincter.
- B. Neutralize gastric secretions.
- C. Ease gastric emptying.
- D. Reduce secretion of digestive juices.
Correct Answer: C
Rationale: Metoclopramide promotes gastric emptying, reducing the volume of gastric contents that can reflux in hiatal hernia.
The client has midcalf pain when walking a block or more. The client states that the discomfort is relieved with rest. The pain is expected when arterial occlusion reaches which of the following percentages?
- A. 20%
- B. 40%
- C. 50%
- D. 100%
Correct Answer: C
Rationale: Claudication typically occurs when arterial occlusion reaches approximately 50%, significantly reducing blood flow to muscles during activity. This causes ischemia and pain, which is relieved by rest when oxygen demand decreases. Complete (100%) occlusion would cause rest pain or tissue necrosis, not just claudication.
One month following a subtotal gastrectomy for cancer, the nurse is evaluating the nursing care goal related to nutrition. Which of the following indicates that the client has attained the goal? The client has:
- A. Regained weight loss.
- B. Resumed normal dietary intake of three meals a day.
- C. Controlled nausea and vomiting through regular use of antiemetics.
- D. Achieved optimal nutritional status through oral or parenteral feedings.
Correct Answer: D
Rationale: Achieving optimal nutritional status, whether through oral or parenteral feedings, is the primary goal one month post-gastrectomy, as it indicates the client is meeting nutritional needs.