Nokea
Which of the following post-operative diets is most appropriate for the client who has had a hemorrhoidectomy?
- A. High-fiber
- B. Low-residue
- C. Bland
- D. Clear-liquid
Correct Answer: D
Rationale: The correct answer is 'Clear-liquid.' After a hemorrhoidectomy, the client is usually started on a clear-liquid diet to allow the intestines to rest and promote healing. This diet helps prevent straining during bowel movements, which is crucial for recovery. Stool softeners are often included in the plan to avoid constipation. Once the client tolerates the clear liquids well, they can progress to a regular diet. High-fiber diet (choice A) is beneficial in the later stages of recovery to prevent constipation but is not typically the initial post-operative diet. Low-residue diet (choice B) and bland diet (choice C) are not appropriate for this type of surgery as they may not provide the necessary post-operative care and support needed for healing.
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A 32-year-old female frequently comes to her primary care provider with vague complaints of headache, abdominal pain, and trouble sleeping. In the past, the physician has dutifully prescribed medication, but little else. Which of the following comments by the nurse to the physician is appropriate?
- A. "Often women who are victims of domestic violence suffer vague symptoms such as abdominal pain."?
- B. "Often women become offended if asked about their safety in relationships."?
- C. "It is mandatory that all women be questioned about domestic violence."?
- D. "How would you feel to know that her partner is beating her and you didn't ask?"?
Correct Answer: A
Rationale: The correct answer is, "Often women who are victims of domestic violence suffer vague symptoms such as abdominal pain."? There is a well-documented correlation between vague symptoms like abdominal pain and battered woman syndrome. It is crucial for healthcare providers to inquire about potential domestic violence when presented with such symptoms. Choice B is incorrect as studies show that women are not generally offended by appropriately phrased questions about their safety in relationships. While it is not mandatory to question all women about domestic violence, it is advisable to at least ask a screening question regarding safety. Choice D is inappropriate as it uses a shaming tactic, which is not constructive and may create a hostile work environment. It's important for healthcare professionals to approach sensitive topics like domestic violence with empathy and professionalism.
The nurse is developing a care plan for a client with severe anxiety. An appropriate outcome for the client is that within 4 days the client should:
- A. Have decreased anxiety.
- B. Talk to the nurse for 10 minutes.
- C. Sit quietly for 30 minutes.
- D. Develop an adaptive coping mechanism.
Correct Answer: B
Rationale: When developing outcome criteria for a client with severe anxiety, it is crucial for the goals to be specific, measurable, and realistic. In this scenario, the most appropriate outcome is for the client to talk to the nurse for 10 minutes within 4 days. This goal is specific (talking for a defined duration), measurable (10 minutes), and realistic given the client's condition. Expecting a severely anxious client to sit quietly for 30 minutes is not realistic and may even exacerbate their anxiety. While developing an adaptive coping mechanism is important, it is a broader long-term goal and may not be achievable within the specified timeframe. Having decreased anxiety is a desirable outcome, but it lacks specificity and measurability, making it less suitable as an immediate goal.
A 24-year-old female client is scheduled for surgery in the morning. What is the primary responsibility of the nurse?
- A. Taking the vital signs
- B. Obtaining the permit
- C. Explaining the procedure
- D. Checking the lab work
Correct Answer: A
Rationale: The primary responsibility of the nurse is to take the vital signs before any surgery. This action helps assess the client's baseline condition and identify any abnormalities that need addressing before the procedure. Obtaining the permit (choice B) is typically handled by administrative staff, explaining the procedure (choice C) is usually done by the healthcare provider performing the surgery, and checking the lab work (choice D) is often part of the pre-operative assessment conducted by the healthcare provider. Therefore, in this context, these actions are not the primary responsibility of the nurse.
What can the nurse instruct the mother of a teething 9-month-old infant to relieve discomfort?
- A. Rub the infant's gums with baby aspirin dissolved in water.
- B. Obtain an over-the-counter (OTC) topical medication for gum pain relief.
- C. Schedule an appointment with a dentist for a dental evaluation.
- D. Give the infant cool liquids or a Popsicle and hard foods such as dry toast.
Correct Answer: D
Rationale: Teething in infants can cause discomfort, but it is a normal process. Symptoms may include nighttime awakening, daytime restlessness, excess drooling, and temporary loss of appetite. The recommended approach to relieve teething discomfort includes providing cool liquids, a Popsicle, or hard foods like dry toast for chewing. These items can help soothe the infant's gums. Rubbing the gums with baby aspirin dissolved in water is not recommended as it can be harmful. OTC topical medications are unnecessary for teething discomfort. Scheduling a dental evaluation is not required solely for teething. It's important to avoid home remedies like baby aspirin and opt for safer options like cool liquids. If necessary, acetaminophen (Tylenol) can be used under healthcare provider guidance to alleviate discomfort.
A new nursing graduate indicates in charting entries that he is a licensed practical nurse, although he has not yet received the results of the licensing exam. The graduate's action can result in what type of charge?
- A. Fraud
- B. Tort
- C. Malpractice
- D. Negligence
Correct Answer: A
Rationale: The correct answer is 'Fraud.' Identifying oneself as a nurse without a license defrauds the public and can lead to prosecution. A tort is a wrongful act in breach of a legal duty imposed by law; malpractice is the failure to act appropriately as a nurse or acting in a way that harm comes to the client; and negligence is failing to perform care. In this scenario, the key issue is the misrepresentation of licensure status, which constitutes fraud. Therefore, choices B, C, and D are incorrect.