Nokea
You are a Drug Abuse Treatment and Rehabilitation Center Nurse. During the assessment of a newly admitted Person Who Uses Drugs (PWUDs) named Korino, which of the following is the MOST APPROPRIATE question to ask?
- A. Ask Korino how long he thought that he could take drugs without someone finding it.
- B. Ask Korino why he started taking illegal drugs.
- C. Not ask any questions for fear Korino will deny and may become assaultive.
- D. Ask Korino about the amount of drug used and its effect and how long he had been using.
Correct Answer: D
Rationale: The most appropriate question to ask during the assessment of a newly admitted Person Who Uses Drugs (PWUDs) like Korino is to ask about the amount of drug used, its effects, and how long he has been using. This question provides valuable information for treatment planning and understanding the extent of Korino's drug use. By asking about the specific details of his drug use, the nurse can assess the severity of the addiction, potential health risks, and the duration of substance abuse. This information is crucial for developing an individualized treatment plan and providing appropriate care for Korino's needs. Asking open-ended questions about drug use also helps build rapport and trust between the nurse and the patient, which is essential for effective treatment.
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Non verbal communication is the behavior that accompanies verbal communication, which of the following is NOT an indicator of this
- A. Eye contact
- B. Grunts and groans
- C. Words representing an object
- D. Bochy language
Correct Answer: C
Rationale: Nonverbal communication consists of gestures, facial expressions, body language, posture, tone of voice, touch, and eye contact, among other behaviors. Option C, words representing an object, refers to verbal communication rather than nonverbal communication. Nonverbal communication is the behavior that accompanies verbal communication, providing additional layers of meaning and adding context to the spoken words. Therefore, words representing an object are not indicators of nonverbal communication.
A patient with a history of multiple myeloma presents with weakness, bone pain, and recurrent infections. Laboratory tests reveal anemia, hypercalcemia, renal insufficiency, and monoclonal spike on serum protein electrophoresis. Which of the following conditions is most likely to cause these findings?
- A. Waldenstrom macroglobulinemia
- B. Hodgkin lymphoma
- C. Chronic lymphocytic leukemia (CLL)
- D. Multiple myeloma
Correct Answer: D
Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.
Which nursing intervention constitutes false imprisonment?
- A. A client is hospitalized as an involuntary admission and attempts to leave the unit. The nurse calls the security team per hospital protocol. They prevent the client from leaving.
- B. A psychotic client is admitted as an involuntary client and runs out of the psychiatric unit. The nurse runs after the client and succeeds in talking the client into returning to the unit.
- C. The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day.
- D. The client is confused, combative, and insists that no one can stop him from leaving. The nurse restrains the client without a physician's order, then seeks the order.
Correct Answer: D
Rationale: False imprisonment occurs when a client is physically restrained or confined without legal justification. In this scenario, the nurse restraining the confused and combative client without a physician's order constitutes false imprisonment. Restraints should only be used when necessary to ensure the safety of the client or others, and a physician's order is required to authorize their use. In this case, the nurse acted without proper authorization, making it a violation of the client's rights and false imprisonment. It is essential to follow proper protocols and obtain necessary orders before restraining a client.
Choose how many times at least the nurses conducts physical assessment to school children.
- A. Thrice a year
- B. Every semester
- C. Every quarter
- D. Once a year
Correct Answer: A
Rationale: It is recommended for nurses to conduct physical assessments on school children at least three times a year, or thrice a year. This frequency allows nurses to monitor the children's growth and development, assess any changes in their health status, and provide early intervention if needed. Regular physical assessments help ensure that any health issues are identified promptly and addressed appropriately, promoting the overall well-being and academic performance of the students.
A primigravida at 40 weeks gestation is in active labor. The nurse notes late decelerations on the fetal monitor tracing. What action should the nurse take first?
- A. Administer oxygen to the mother.
- B. Change the mother's position.
- C. Prepare for immediate delivery.
- D. Discontinue oxytocin infusion.
Correct Answer: D
Rationale: Late decelerations on the fetal monitor tracing indicate a potential uteroplacental insufficiency, which could be caused by decreased oxygen supply to the fetus. One common cause of late decelerations is uterine hyperstimulation due to excessive use of oxytocin. By discontinuing the oxytocin infusion, the nurse can help alleviate the stress on the fetus and decrease the likelihood of further late decelerations. This action should be prioritized before other interventions such as changing the mother's position or administering oxygen. Immediate delivery may be necessary if the fetus continues to show signs of distress despite discontinuing the oxytocin infusion.