Which of the following statements should the nurse make?
- A. Do you need a prescription for an antianxiety medication?
- B. Do you need information on hospice care?
- C. Would you like to talk to a counselor about advance directives?
- D. Would you like to speak to a spiritual advisor?
Correct Answer: D
Rationale: Spiritual support can help address emotional and existential concerns in terminally ill clients.
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Select the 5 findings the nurse should plan to include in the report.
- A. Client's report of lack of food in home
- B. ECG results
- C. Numerous bruises in various stages of healing
- D. Client's avoidance of eye contact
- E. Client's report of lack of access to bank accounts
- F. Client’s report of weight loss
Correct Answer: A,C,D,E,F
Rationale: These findings highlight potential abuse and neglect indicators.
Which of the following information should the nurse include in the teaching?
- A. Take mineral oil at bedtime
- B. Decrease insoluble fiber intake
- C. Drink 1,5 L of fluids each day.
- D. Increase exercise activity.
Correct Answer: D
Rationale: The correct answer is D: Increase exercise activity. This is important for promoting regular bowel movements and overall gastrointestinal health. Exercise helps stimulate the digestive system and aids in relieving constipation. Taking mineral oil (choice A) can interfere with nutrient absorption and is not recommended for long-term use. Decreasing insoluble fiber intake (choice B) can worsen constipation as fiber helps promote bowel regularity. Drinking 1.5 L of fluids each day (choice C) is important for hydration but alone may not be sufficient to improve bowel function. Increasing exercise activity (choice D) is the most effective way to promote healthy digestion and prevent constipation.
Which of the following actions should the nurse take?
- A. Infuse the medication over 10 min
- B. Instruct the client to notify the provider if diarrhea develops
- C. Refrigerate the medication after reconstitution.
- D. Check the client for a sulfa allergy.
Correct Answer: B
Rationale: The correct answer is B: Instruct the client to notify the provider if diarrhea develops. This action is important because diarrhea can be a potential side effect of medication, especially antibiotics, and may indicate a serious adverse reaction. It is crucial for the client to inform the provider promptly to prevent complications.
Choice A is incorrect as it refers to a specific administration instruction for a medication, not related to client monitoring. Choice C is incorrect as it pertains to storage of medication, not client education. Choice D is incorrect as it focuses on assessing for a specific allergy, not related to ongoing client monitoring.
Which of the following dysrhythmias is the client displaying?
- A. First-degree atrioventricular block
- B. Complete heart block
- C. Premature atrial complexes
- D. Atrial fibrillation
Correct Answer: A
Rationale: The correct answer is A: First-degree atrioventricular block. This dysrhythmia is characterized by a delay in conduction at the atrioventricular node, causing a prolonged PR interval (>0.20 sec) on ECG. It is a benign condition and does not typically require treatment unless symptomatic. Choices B and D are more serious dysrhythmias that have different ECG patterns and clinical implications. Complete heart block (Choice B) presents with a lack of conduction between the atria and ventricles, leading to a slow ventricular rate. Atrial fibrillation (Choice D) is characterized by rapid, irregular atrial depolarizations without effective atrial contractions. Premature atrial complexes (Choice C) are early ectopic atrial beats that appear as abnormal P waves on ECG but do not cause significant conduction delays.
Which of the following conflict-resolution strategies should the charge nurse use?
- A. Encourage collaboration between the two nurses when making the assignments
- B. Ask each nurse to take turns making the assignments.
- C. Tell the nurses that the assignments will be more equitable in the future.
- D. Arrange for the nurses to have as few shifts together as possible
Correct Answer: A
Rationale: The correct answer is A: Encourage collaboration between the two nurses when making the assignments. This strategy fosters open communication and teamwork, leading to a mutually agreed-upon solution. It promotes a sense of ownership and shared responsibility, enhancing job satisfaction and reducing conflict. Choice B may not address the underlying issues causing conflict. Choice C is vague and lacks a specific action plan. Choice D avoids the conflict rather than resolving it.