Nokea
Which reaction toward the physical symptom would the nurse observe in a client with conversion disorder?
- A. Anger
- B. Apathy
- C. Anxiety
- D. Agitation
Correct Answer: B
Rationale: In conversion disorder, the nurse would observe apathy toward the physical symptom. The development of the symptom serves as an unconscious method of reducing anxiety. The symptom is accepted passively, known as 'la belle indifférence.' There is no anger observed as symptoms are passively accepted. Similarly, there is no direct anxiety related to the physical symptom, as the conflict is resolved through the symptom development. While many individuals might experience agitation and seek to identify the cause of physical symptoms, in conversion disorder, there is an unusual calmness or indifference towards the physical manifestation, indicating apathy rather than other emotional responses.
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After undergoing dilation and curettage following an early miscarriage, a client is crying. Which response would the nurse give?
- A. This must be a very difficult experience for you to deal with.''
- B. You'll have other children to take the place of the child you lost.''
- C. Of course you're sad now, but at least you know you can get pregnant.''
- D. I know how you feel, but when a woman miscarries, it's usually for the best.''
Correct Answer: A
Rationale: The correct response acknowledges the client's grief without judgment and provides validation. Choice B is inappropriate as it suggests replacing the lost child with other children, which is insensitive and dismissive of the client's current loss. Choice C minimizes the client's feelings by focusing on the ability to get pregnant rather than addressing the emotional impact of the miscarriage. Choice D is dismissive and patronizing, suggesting that the miscarriage was for the best, which can be hurtful and diminish the client's grief.
A 16-year-old client diagnosed with diabetes is admitted for hyperglycemia. The client states, 'I'm fed up with having my life ruled by diets, doctors' prescriptions, and machines!' Based on this assessment data, which is the priority client concern?
- A. A chronic illness
- B. A personal crisis
- C. Feelings of loss of control
- D. Lack of understanding about nutrition
Correct Answer: C
Rationale: Adolescents strive for identity and independence, and the situation describes a common fear of loss of control. Therefore, the priority problem relates to these feelings of loss of control. Although the child has a chronic illness and may be experiencing a personal crisis, the child's statement focuses on loss of control. There is no information in the question that indicates a lack of knowledge.
The nurse is seeing a client in the clinic with her 18-month-old daughter. The client asks the nurse when her child should start going to the dentist. Which response by the nurse is correct?
- A. She should go by her first birthday.
- B. She should start receiving oral exams at 2 years of age.
- C. She should go to a dentist once a year beginning at age 3.
- D. You don't need to worry about it until she starts kindergarten.
Correct Answer: A
Rationale: The American Academy of Pediatric Dentistry recommends a dental visit by the first birthday to establish a dental home and prevent early childhood caries.
Which method is used to verify the placement of a newly inserted central venous access device (CVAD)?
- A. Chest x-ray
- B. Flushing the line with heparin
- C. Withdrawing blood to ensure patency
- D. Chest fluoroscopy
Correct Answer: A
Rationale: The correct method to verify the placement of a newly inserted central venous access device (CVAD) is a chest x-ray. This is crucial to detect any potential complications such as pneumothorax, which can occur during subclavian vein catheter insertion. Symptoms of pneumothorax may include shortness of breath and anxiety. Flushing the line with heparin is not used for placement verification, but rather for maintaining patency after verification. Withdrawing blood to ensure patency is done after placement is confirmed, not for initial verification. Chest fluoroscopy may be used during the insertion process but is not typically employed for placement verification.
A client diagnosed with angina pectoris is extremely anxious after being hospitalized. Which should the nurse do to minimize the client's anxiety?
- A. Provide care choices to the client.
- B. Keep the door open and the hallway lights on at night.
- C. Encourage the client to limit visitors to as few as possible.
- D. Arrange for the client to share a room with a cognitively alert client.
Correct Answer: A
Rationale: General interventions to minimize anxiety in the hospitalized client include providing information, social support, and control over choices related to care, as well as acknowledging the client's feelings. Leaving the door open with the hallway lights on may keep the client oriented, but these actions may interfere with sleep and increase anxiety. Limiting visitors reduces social support. The sharing of a room may not necessarily meet the client's needs.