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Which position is recommended for a patient who has difficulty breathing or respiratory distress?
- A. Supine position
- B. Prone position
- C. Fowler's position
- D. Side-lying position
Correct Answer: C
Rationale: For patients struggling with breathing or respiratory distress, elevating the head in a sitting or semi-sitting position maximizes lung expansion and eases respiratory effort. This approach leverages gravity to assist diaphragm movement, improving oxygenation, which is vital in conditions like pneumonia or heart failure. Lying flat on the back can compress the chest, worsening distress, while lying on the stomach is impractical and may obstruct airflow for such patients. Positioning on the side might help in specific cases, like unilateral lung issues, but it's less universally effective for general respiratory support. Nurses choose this position to optimize airway clearance and comfort, directly addressing the physiological need for better ventilation in acute respiratory challenges.
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The nurse is caring for a client after a stroke rendered the client's right side weaker than the left. The nurse coordinates the plan of care with the physical therapist. The nurse's interventions reflect which one of nursing's four broad goals?
- A. To promote health
- B. To prevent illness
- C. To restore health
- D. To facilitate coping with death and/or disability
Correct Answer: C
Rationale: Nursing practice is guided by four broad goals that shape interventions based on client needs. In this scenario, the nurse's coordination with a physical therapist to address the client's weakened right side post-stroke aligns with the goal of restoring health. This involves efforts to regain lost function, improve strength, and enhance the client's physical capacity following an illness or injury. Promoting health focuses on maintaining wellness before illness occurs, such as through lifestyle education, while preventing illness aims to stop disease onset, like via vaccinations. Facilitating coping with death or disability pertains to supporting clients and families through terminal conditions or permanent impairments, not necessarily recovery. Here, the emphasis is on rehabilitation and recovery, targeting the restoration of the client's pre-stroke abilities as much as possible. This collaborative approach underscores nursing's role in helping clients reclaim their health after a significant medical event, aligning with the restorative aim.
The nurse is assisting in planning care for a client scheduled for insertion of a tracheostomy. Which equipment should the nurse plan to have at the bedside when the client returns from surgery?
- A. Obturator
- B. Oral airway
- C. Epinephrine
- D. Tracheostomy tube with the next larger size
Correct Answer: A
Rationale: Post-tracheostomy, the obturator (A) is essential at the bedside to reinsert the tube if dislodged, ensuring airway patency. An oral airway (B) is irrelevant for tracheostomy patients. Epinephrine (C) treats allergic reactions, not routine needs. A larger tracheostomy tube (D) isn't standard emergency equipment. A is correct. Rationale: The obturator facilitates immediate tube replacement, critical in the first 72 hours before a tract forms, preventing airway loss, a priority per surgical nursing standards over other less relevant items.
He proposed the theory of morality based on PRINCIPLES
- A. Freud
- B. Erikson
- C. Kohlberg
- D. Peters
Correct Answer: D
Rationale: R.S. Peters' moral theory (1960s) centers on principles justice, honesty e.g., a nurse acts kindly from habit. Freud's drives, Erikson's stages, and Kohlberg's trust differ. Peters' view of morality as emotion, judgment, and behavior guides ethical consistency e.g., reporting errors impacting nursing's professional conduct and standards.
Caring involves 5 processes, KNOWING, BEING WITH, DOING FOR, ENABLING and MAINTAINING BELIEF.
- A. Benner
- B. Watson
- C. Leininger
- D. Swanson
Correct Answer: D
Rationale: Kristen Swanson's Theory of Caring, from the 1990s, outlines five processes: knowing (understanding the patient's experience), being with (offering presence), doing for (performing tasks patients can't), enabling (empowering self-care), and maintaining belief (instilling hope). Unlike Benner's expertise model, Watson's spiritual focus, or Leininger's cultural lens, Swanson's framework is practical and patient-centered. For instance, a nurse might ‘know' a cancer patient's fears, ‘be with' them during chemo, ‘do for' by administering meds, ‘enable' through education, and ‘maintain belief' by affirming recovery potential. Grounded in empirical research, her theory guides nurses in holistic care, particularly in maternal or end-of-life settings, emphasizing relational depth over technical skill alone.
The nurse is caring for a client with a spinal cord injury at T10. Which finding indicates that the client is experiencing spinal shock?
- A. Absence of reflexes below the injury
- B. Blood pressure of 180/100 mm Hg
- C. Spasticity of the lower extremities
- D. Sweating above the level of injury
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.