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You are a home health nurse caring for an elderly client in their home. They have children and grandchildren but they live far from the client and they typically visit with your clients once to two times a year. The elderly man is beginning to show some of the signs of Alzheimer's disease dementia. The wife is also 88 years of age and has had a stroke which has left her with left sided weakness, but she is willing to help her husband and to maintain his safety. What kind of support should you give the wife in terms of her role caring for her husband?
- A. You should advise the couple to move closer to their children so that they can care for their father.
- B. You should teach the wife about this progressive disease and the need to promote as much independence as possible.
- C. You should teach the wife about this progressive disease and the need to do all that she can for the husband to avoid his depression and frustration.
- D. You should advise the couple to decrease their social activities in order to preserve the husband's dignity and self-esteem.
Correct Answer: B
Rationale: Educating the wife about Alzheimer's disease and promoting the husband's independence as much as possible supports safety and dignity while respecting her role as a caregiver with physical limitations.
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Sexually transmitted diseases are communicable diseases that must be reported. The nurse is responsible for reporting these diseases to the appropriate public health agency, and to maintain the patient's confidentiality. The client's family cannot request release of medical information without the client's consent. A physician's order is not a substitute for a client's consent to release medical information in the absence of a communicable disease.
- A. Report the disease to the public health agency while maintaining confidentiality.
- B. Share the information with the client's family.
- C. Obtain a physician's order to release information.
- D. Disclose the information to the client's employer.
Correct Answer: A
Rationale: Reporting STDs to public health agencies is mandatory, but confidentiality must be maintained except in specific legal circumstances.
The nurse is reviewing the care plan of a client diagnosed with having the deficits associated with a right-sided stroke. The nurse notes documentation that the client has unilateral neglect with left-sided deficits. The nurse plans care with the understanding that which action would be least helpful?
- A. Place bedside articles on the left side.
- B. Approach the client from the right side.
- C. Teach the client to scan the environment.
- D. Move the commode and chair to the left side.
Correct Answer: B
Rationale: Unilateral neglect is an unawareness of the paralyzed side of the body, which increases the client's risk for injury. The nurse's role is to refocus the client's attention to the affected side. Personal care items, belongings, a bedside chair, and a commode are all placed on the affected side. The client is taught to scan the environment to become aware of that half of the body and is approached on that side by family and caregivers as well.
The registered nurse, prior to the delegation of tasks to other members of the nursing care team, evaluates the ability of staff members to perform assigned tasks for the position as based on which legal consideration?
- A. The American Nurses Association's Scopes of Practice
- B. The American Nurses Association's Standards of Care
- C. State statutes
- D. Federal law
Correct Answer: C
Rationale: Delegation of tasks by a registered nurse must comply with state statutes , which define the scope of practice and delegation authority for nurses and other healthcare team members within each state. These laws ensure that tasks are delegated to individuals who are legally qualified to perform them.
An intravenous dose of lorazepam is prescribed for a client. Which data from the client's history would indicate the need to consult with the primary health care provider before administering the medication?
- A. Glaucoma
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Coronary artery disease
Correct Answer: A
Rationale: Lorazepam is a benzodiazepine and is contraindicated in clients who are comatose, with preexisting central nervous system (CNS) depression, with uncontrolled severe pain, and those with narrow-angle glaucoma. It is also contraindicated if hypersensitivity or cross-sensitivity with other benzodiazepines exists. It is also not prescribed for clients who are pregnant or breast-feeding.
The nurse is caring for a client with bipolar disorder in a manic phase. Which intervention is most appropriate?
- A. Encourage group activities.
- B. Provide a quiet environment.
- C. Allow unlimited phone calls.
- D. Offer high-calorie snacks.
Correct Answer: B
Rationale: A quiet environment reduces stimuli, helping to calm a client in a manic phase.