Nokea
Which of these case management methods employs the intrinsic use of multidisciplinary plans of care that are based on the client's current condition, and reflect interventions and expected outcomes within a pre-established time line?
- A. The Case Manager Model
- B. The ProACT Model
- C. The Collaborative Practice Model
- D. The Triad Model of Case Management
Correct Answer: D
Rationale: The Triad Model of Case Management uses multidisciplinary plans of care based on the client's current condition, with interventions and expected outcomes within a pre-established timeline, involving collaboration among nursing, social work, and utilization review teams.
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A client admitted with a gastric ulcer has been vomiting bright red blood. His hemoglobin level is 5.11 g/dL, and his blood pressure is 100/50 mm Hg. The client and his family state that their religious beliefs do not support the use of blood products and refuse blood transfusions as a treatment for the bleeding. The nurse should collaborate with the physician and family to next:
- A. Discontinue all measures.
- B. Notify the hospital attorney.
- C. Attempt to stabilize the client through the use of fluid replacement.
- D. Give enough blood to keep the client from dying.
Correct Answer: C
Rationale: Respecting the client's religious beliefs, the nurse should focus on stabilizing the client with fluid replacement to address hypovolemia, as blood transfusions are refused.
A client with a history of systemic lupus erythematosus (SLE) reports joint pain and fatigue. Which intervention should the nurse prioritize?
- A. Administer analgesics as ordered
- B. Encourage high-impact exercise
- C. Apply cold packs to joints
- D. Restrict fluid intake
Correct Answer: A
Rationale: Administering analgesics addresses joint pain, a common SLE symptom, improving comfort and quality of life.
A client with a history of chronic kidney disease is prescribed calcium carbonate (Tums). The nurse should instruct the client to:
- A. Take the medication between meals.
- B. Take the medication with meals.
- C. Avoid taking the medication with dairy products.
- D. Stop the medication if constipation occurs.
Correct Answer: B
Rationale: Calcium carbonate should be taken with meals to bind phosphate in the gut, managing hyperphosphatemia in kidney disease.
Which action by the nursing student, caring for a child who sustained a head injury from a fall, indicates a need for further teaching?
- A. Forcing fluids
- B. Performing neurological assessments
- C. Keeping the child in a sitting-up position
- D. Keeping the child awake as much as possible
Correct Answer: A
Rationale: A child with a head injury is at risk for increased intracranial pressure (ICP). Forcing fluids may cause fluid overload and increased ICP. Additionally, the nurse should not 'force' the client to do something. Neurological assessments must be performed to monitor for increased ICP. Sitting up will decrease fluid retention in cerebral tissue and promote drainage. Keeping the child awake will assist in accurate evaluation of any cerebral edema that is present and will detect early coma.
Select the sound that is heard with percussion with its description.
- A. Tympany: A hollow sound
- B. Dullness: A thud like sound
- C. Dullness: A hollow sound
- D. Resonance: A booming sound
Correct Answer: A,B,D
Rationale: Tympany is a hollow sound (e.g., over air-filled structures like the stomach), dullness is a thud-like sound (e.g., over solid organs like the liver), and resonance is a booming sound (e.g., over lung tissue). Option C is incorrect because dullness is not a hollow sound.