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1. An adult male was diagnosed with stage IV lung cancer three weeks ago. His wife approaches the nurse and asks how she will know that her husband's death is imminent because their two adult children want to be there when he dies. What is the best response by the nurse?
- A. Explain that the client will start to lose consciousness and his body systems will slow down
- B. Reassure the spouse that the healthcare provider will let her know when to call the children
- C. Offer to discuss the client’s health status with each of the adult children
- D. Gather information on how long it will take for the children to arrive
Correct answer: A
Rationale: The best response for the nurse is to explain that the client will start to lose consciousness and his body systems will slow down. Providing information on the signs of impending death helps the family prepare emotionally and allows them to be present at the appropriate time. Choice B is incorrect because it does not empower the family with the knowledge they seek. Choice C is incorrect as discussing the client’s health status individually with the adult children may not address the wife's immediate concern. Choice D is incorrect as the priority should be on preparing the family for the signs of imminent death rather than focusing on logistical details.
2. After the diagnosis and initial treatment of a 3-year-old with Cystic fibrosis, the nurse provides home care instructions to the mother. Which statement by the child's mother indicates that she understands home care treatment to promote pulmonary functions?
- A. Chest physiotherapy should be performed twice a day before a meal
- B. Energy should be conserved by scheduling minimally strenuous activities
- C. Administer a cough suppressant every 8 hours
- D. Maintain supplemental oxygen at 4 to 6 L/minute
Correct answer: A
Rationale: The correct answer is A. Chest physiotherapy is essential for maintaining pulmonary function in cystic fibrosis. It should be performed regularly, often twice daily, to clear mucus from the lungs. Choice B is incorrect because conserving energy does not directly promote pulmonary function. Choice C is incorrect as cough suppressants are not typically used to promote pulmonary function in cystic fibrosis. Choice D is incorrect as maintaining supplemental oxygen at 4 to 6 L/minute is not a standard home care treatment for promoting pulmonary functions in cystic fibrosis.
3. What is the best response when a two-year-old boy begins to cry when his mother starts to leave?
- A. Say, 'Let's wave bye-bye to Mommy.'
- B. Say, 'Let me read this book to you.'
- C. Say, 'Two-year-olds usually stop crying the minute the parent leaves.'
- D. Say, 'Now, now, be a big boy, Mommy will be back soon.'
Correct answer: B
Rationale: The best response in this situation is to offer a distraction to the child. Reading a book can help soothe the child during separation from the parent by redirecting their attention. Choice A might not be as effective as providing a distraction like reading a book. Choice C dismisses the child's feelings and generalizes behavior, which is not helpful. Choice D diminishes the child's emotions and does not provide a constructive way to help the child cope with the separation anxiety.
4. A young adult male who is being seen at the employee health care clinic for an annual assessment tells the nurse that his mother was diagnosed with schizophrenia when she was his age and that life with a schizophrenic mother was difficult indeed. Which response is best for the nurse to provide?
- A. Ask the client if he is worried about becoming schizophrenic at the age his mother was diagnosed.
- B. Encourage the client to seek genetic counseling to determine his risk for mental illness.
- C. Inform the client that his mother’s schizophrenia has affected his psychological development.
- D. Tell the client that mental illness has a familial predisposition so he should see a psychiatrist.
Correct answer: B
Rationale: Genetic counseling can help assess risk and provide guidance for the client’s concerns about potential hereditary conditions.
5. The nurse is managing the care of a client with Cushing's syndrome. Which interventions should the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply)
- A. Evaluate the client for sleep disturbances
- B. limit client exercise
- C. Report any client complaint of pain or discomfort
- D. Note and report the client's food and liquid intake during meals and snacks
Correct answer: D
Rationale: Weighing the client and monitoring food and liquid intake are appropriate tasks to delegate to the unlicensed assistive personnel (UAP) when managing a client with Cushing's syndrome. These tasks provide essential information for evaluating the client's condition and response to treatment. Evaluating for sleep disturbances and reporting client complaints of pain or discomfort require a higher level of assessment and interpretation, which should be performed by licensed healthcare providers. Therefore, options A and C are tasks that involve assessment and interpretation beyond the scope of practice for UAP.
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