During the last 30 days, an elderly client has exhibited a progressively decreasing appetite, is spending increasing amounts of daytime hours in bed, and refuses to participate in planned daytime activities. Which action should the practical nurse take?

A. Record the findings and report the symptoms to the charge nurse

B. Ask the family members to visit more often to stimulate the patient

C. Motivate the client by offering favorite foods as a prize

D. Withhold any medications that may cause side effects

Correct Answer: A
Rationale: The practical nurse should record the findings and report the symptoms to the charge nurse. These behaviors may indicate a serious underlying condition such as depression or physical illness. By reporting to the charge nurse, the client can receive appropriate assessment and intervention promptly. Choice B is incorrect as family visits may not address the root cause of the symptoms. Choice C is incorrect as it oversimplifies the situation and may not be effective in addressing the underlying issue. Choice D is incorrect because withholding medications without proper assessment and guidance can be harmful to the client's health.

Which of the following areas does the Patient’s Bill of Rights cover?

• A. Information disclosure
• B. Choice of providers
• C. Choice of plans
• D. All of the above

Correct Answer: D
Rationale: The Patient’s Bill of Rights encompasses various areas to protect patients' rights. These include ensuring information disclosure, allowing patients to choose their healthcare providers, and giving them options to select plans that suit their needs. Therefore, all the choices - information disclosure, choice of providers, and choice of plans - are covered under the Patient’s Bill of Rights. The option 'Best payment options' is not relevant to the areas typically addressed by the Patient’s Bill of Rights.

Which nursing intervention is most appropriate for managing delirium in an elderly patient?

• A. Keeping the room brightly lit
• B. Administering sedatives as needed
• C. Encouraging family presence
• D. Restricting fluids

Correct Answer: C
Rationale: Encouraging family presence is the most appropriate intervention for managing delirium in elderly patients. This intervention provides orientation, reassurance, and comfort, which can help reduce confusion and anxiety, thus aiding in managing delirium. Keeping the room brightly lit (Choice A) may worsen delirium as it can disrupt the patient's sleep-wake cycle. Administering sedatives (Choice B) should be avoided unless absolutely necessary due to the risk of worsening delirium. Restricting fluids (Choice D) is not a recommended intervention for managing delirium, as hydration is important for overall patient well-being.

What disorder closely matches Suzy's symptoms?

• A. Antisocial personality disorder
• B. Borderline personality disorder
• C. Schizoid personality disorder
• D. Dissociative Identity Disorder

Correct Answer: B
Rationale: Suzy's symptoms are characteristic of Borderline Personality Disorder (BPD). BPD includes instability in relationships, self-image, and emotions, as well as impulsivity and self-harm. Choice A, Antisocial personality disorder, is characterized by a disregard for others' rights and lack of empathy, which does not align with Suzy's symptoms. Schizoid personality disorder, choice C, is characterized by a lack of interest in social relationships, which is not a prominent feature in Suzy's case. Dissociative Identity Disorder, choice D, involves the presence of two or more distinct identities or personality states, which is not reflected in Suzy's symptoms.

A client who had a right total shoulder replacement is being prepared for discharge. What should the nurse emphasize to the client to prevent complications?

• A. Avoid lifting objects with the right arm until cleared by the surgeon.
• B. Perform shoulder exercises to regain strength.
• C. Use a sling at all times, even during sleep.
• D. Apply heat to the shoulder to reduce stiffness.

Correct Answer: A
Rationale: The correct answer is to avoid lifting objects with the right arm until cleared by the surgeon. After a total shoulder replacement, it is essential to protect the new joint to prevent dislocation or injury. Lifting heavy objects prematurely can lead to complications. While performing shoulder exercises is important for strength, they should be done as per the healthcare provider's instructions to avoid strain on the new joint. Using a sling at all times, as in choice C, is not necessary once the client has regained enough strength and mobility. Applying heat, as in choice D, may not be recommended post-surgery; cold therapy is often preferred to reduce swelling and pain.