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1. A client has expressive aphasia following a stroke. Which of the following methods should be used when communicating with the client?
- A. Speak slowly
- B. Provide written instructions
- C. Use a picture board
- D. Write on a whiteboard
Correct answer: C
Rationale: When communicating with a client who has expressive aphasia, using a picture board is an effective method as it provides an alternative means of communication. Option A, speaking slowly, may not improve understanding for someone with expressive aphasia. Option B, providing written instructions, may also be challenging for individuals with this condition. Option D, writing on a whiteboard, may not be as helpful as using a picture board in facilitating communication for a client with expressive aphasia.
2. A nurse is reviewing the medical history of a client with dementia. Which of the following findings should the nurse address first?
- A. Restlessness and agitation
- B. Decreased respiratory rate
- C. Wandering during the night
- D. Incontinence
Correct answer: A
Rationale: In a client with dementia, addressing restlessness and agitation is a priority because these symptoms can exacerbate dementia and lead to further complications. Restlessness and agitation can indicate underlying issues such as pain, discomfort, or unmet needs, which should be promptly assessed and managed to improve the client's quality of life. Decreased respiratory rate, wandering during the night, and incontinence are important to address but do not pose immediate risks to the client's well-being compared to the potential effects of unmanaged restlessness and agitation in dementia.
3. A nurse on a med surge unit has received change of shift report and will care for 4 clients. Which of the following clients' needs will the nurse assign to an AP?
- A. Feeding a client who was admitted 24 hours ago with aspiration pneumonia
- B. Reinforcing teaching with a client who is learning to walk with a quad cane
- C. Reapplying a condom catheter for a client who has urinary incontinence
- D. Applying a sterile dressing to a pressure ulcer
Correct answer: C
Rationale: The correct answer is C because reapplying a condom catheter for a client with urinary incontinence is a task that can be safely assigned to an assistive personnel (AP) as it falls within their scope of practice. Choice A involves the assessment of a client with aspiration pneumonia, which requires nursing judgment. Choice B requires teaching and guidance, which is the responsibility of the nurse. Choice D involves applying a sterile dressing, which requires nursing skills and knowledge.
4. A client with chronic kidney disease needs dietary restrictions. What restriction is necessary?
- A. Increase protein intake
- B. Limit potassium-rich foods
- C. Increase fluid intake to prevent dehydration
- D. Increase phosphorus intake
Correct answer: B
Rationale: The correct answer is to limit potassium-rich foods for clients with chronic kidney disease. Excessive potassium can be harmful to individuals with compromised kidney function, leading to complications. This restriction helps in managing the condition and preventing further health issues. Choice A is incorrect because increasing protein intake can put additional stress on the kidneys. Choice C is incorrect as excessive fluid intake can burden the kidneys. Choice D is incorrect as increasing phosphorus intake can be harmful for individuals with kidney disease.
5. What are common signs of hypoglycemia?
- A. Shakiness or Tremors
- B. Sweating
- C. Hunger
- D. Confusion or Irritability
Correct answer: A
Rationale: The correct signs of hypoglycemia include shakiness or tremors, sweating, and hunger. These symptoms indicate low blood sugar levels. Confusion or irritability are more associated with severe hypoglycemia, while the immediate treatment for hypoglycemia involves providing a source of glucose to raise blood sugar levels quickly.
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