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You are caring for a group of clients who are adversely affected with phobias. Which form of group therapy will you most likely employ to treat these clients?
- A. Cognitive psychotherapy
- B. Behavioral psychotherapy
- C. Cognitive behavioral psychotherapy
- D. Psychoanalysis
Correct Answer: C
Rationale: Cognitive behavioral psychotherapy (CBT) is the most effective treatment for phobias, as it combines cognitive restructuring with behavioral techniques like exposure therapy to address irrational fears.
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A client with a fractured femur is in skeletal traction. The nurse should assess for which of the following complications?
- A. Fat embolism.
- B. Hypovolemia.
- C. Osteomyelitis.
- D. Pressure ulcers.
Correct Answer: A, D
Rationale: Fat embolism is a risk with long bone fractures, and pressure ulcers can develop due to immobility in traction.
Immediately after the client receives an injection of bupivacaine (Marcaine), he becomes restless and nervous and reports a feeling of impending doom. Which of the following actions by the nurse is appropriate at this time?
- A. Ask the client to talk more about what he is feeling
- B. Reassure the client that it is normal to feel restless before a procedure
- C. Assess the client's vital signs
- D. Administer epinephrine
Correct Answer: C
Rationale: Restlessness, nervousness, and a feeling of impending doom after bupivacaine injection may indicate systemic toxicity or an allergic reaction, requiring immediate vital sign assessment to guide further action. Talking, reassurance, or administering epinephrine without assessment is premature.
The physician has ordered a low-potassium diet for a client. Which of the following food choices indicates that the client needs further instruction regarding the diet?
- A. Apple.
- B. Baked potato.
- C. Carrots.
- D. Spinach.
Correct Answer: B
Rationale: Baked potatoes are high in potassium, so choosing them indicates a need for further teaching on a low-potassium diet.
The nurse is planning care for a client with a chest tube attached to a chest drainage system. Which actions should the nurse include as part of routine chest tube care? Select all that apply.
- A. Encourage the client to cough and deep breathe.
- B. Add water to the suction chamber as it evaporates.
- C. Keep the collection chamber below the client's waist.
- D. Clamp the chest tube when the client gets out of bed.
- E. Tape the connection between the chest tube and the drainage system.
Correct Answer: A,B,C,E
Rationale: The client is encouraged to cough and deep breathe to assist in lung expansion. Water is added to the suction control chamber as needed to maintain the full suction level prescribed. The nurse keeps the drainage collection system below the level of the client's waist to prevent fluid or air from reentering the pleural space. Connections between the chest tube and system are taped to prevent accidental disconnection. To avoid causing tension pneumothorax, the nurse avoids clamping the chest tube for any reason unless specifically prescribed. In most instances, clamping of the chest tube is contraindicated by agency policy.
A child has been prescribed diphenhydramine hydrochloride (Benadryl) to help control the itching from atopic dermatitis. The nurse should instruct the parents to report: Select all that apply.
- A. Weight loss.
- B. Drowsiness.
- C. Thickened bronchial secretions.
- D. Upset stomach.
- E. Bradycardia.
Correct Answer: B, C, D
Rationale: Diphenhydramine can cause drowsiness, thickened bronchial secretions, and upset stomach as side effects, which should be reported.