Nursing Elites

1. The healthcare provider is assessing several clients before surgery. Which factor in a client's history poses the greatest threat for complications during surgery?

• A. Taking birth control pills for the past 2 years
• B. Taking anticoagulants for the past year
• C. Recently completing antibiotic therapy
• D. Having taken laxatives PRN for the last 6 months

Correct answer: B

Rationale: The correct answer is taking anticoagulants for the past year. Anticoagulants increase the risk of bleeding during surgery, which can lead to complications. It is crucial for the healthcare provider to be aware of this medication. While clients taking birth control pills (option A) may be more prone to developing blood clots, these issues typically arise after surgery. Clients who recently completed antibiotic therapy (option C) or have taken laxatives PRN for the last 6 months (option D) are at lower risk compared to those taking anticoagulants (option B) during surgery.

2. After a client has a spontaneous abortion at 12 weeks' gestation, the nurse notes that both she and her partner are visibly upset and crying. Which statement would be a therapeutic response?

• A. 'I'll be here if you want to talk.''
• B. 'Try to relax"?it'll speed up the healing process.''
• C. 'With any luck, you'll get pregnant again soon.''
• D. 'It's best that this happened early rather than having the baby die after it was born.''

Correct answer: A

Rationale: A therapeutic response in this situation is to offer support and empathy. Saying, 'I'll be here if you want to talk' gives the client and her partner the opportunity to express their emotions and seek comfort. It acknowledges their distress and assures them of the nurse's availability. Choice B, advising to relax to speed up the healing process, dismisses their current emotions and may hinder open communication. Choice C, suggesting getting pregnant again soon, minimizes their grief over the loss and may not be what the couple needs to hear at that moment. Choice D, stating it's best that the miscarriage happened early, is insensitive as it invalidates the couple's feelings of loss and grief. Grieving is a natural process, and the timing of the loss does not diminish its significance.

3. At a senior citizens meeting, a healthcare professional talks with a client who has Type 1 diabetes mellitus. Which statement by the client during the conversation is most predictive of a potential for impaired skin integrity?

• A. ''I give myself insulin injections in my thighs.''
• B. ''Sometimes when I put my shoes on, I don't know where my toes are.''
• C. ''Here are my glucose readings that I noted on my calendar.''
• D. ''If I bathe more than once a week, my skin feels too dry.''

Correct answer: B

Rationale: The correct answer is when the client states, ''Sometimes when I put my shoes on, I don't know where my toes are.'' This statement indicates peripheral neuropathy, which can lead to a lack of sensation in the lower extremities. When clients are unable to feel pressure or pain in their feet, they are at a high risk for skin impairment, such as cuts, wounds, or ulcers. Option A is not directly related to impaired skin integrity, as self-administering insulin in the thighs does not pose a direct risk to skin integrity. Option C shows good glucose monitoring, which is important but does not directly indicate impaired skin integrity. Option D suggests dry skin due to infrequent bathing, which is more related to general skin care and not as predictive of impaired skin integrity as the statement in Option B.

4. Which initial response would the nurse make to a 67-year-old man with type 2 diabetes who sadly confides in the nurse that he has been unable to have an erection for several years?

• A. 'At your age, sex isn't that important.''
• B. ''That is a natural occurrence at your age.''
• C. ''You sound upset about not being able to have an erection.''
• D. 'Maybe it's time for you to speak to your primary health care provider about this.''

Correct answer: C

Rationale: The correct response is, 'You sound upset about not being able to have an erection.' When a client discloses personal information, the nurse should respond in a non-judgmental manner to encourage further communication and gather more details. This response demonstrates empathy and understanding, opening the door for the patient to express his feelings and concerns. Choice A, 'At your age, sex isn't that important,' is dismissive and fails to address the client's emotions or concerns, potentially hindering open communication. Choice B, 'That is a natural occurrence at your age,' provides inaccurate information as the inability to have an erection is not considered a normal part of aging. Choice D, 'Maybe it's time for you to speak to your primary health care provider about this,' while important eventually, should not be the initial response as the nurse should first explore the client's feelings and concerns before discussing potential referrals or interventions.

5. Which instruction should the nurse provide to a preschool-age client to prevent altered growth and development?

• A. Trust
• B. Empathy
• C. Impulse control
• D. Problem-solving

Correct answer: C

Rationale: Teaching a preschool-age child and their parents about the importance of impulse control is essential to prevent the risk of altered growth and development. Preschool-age children are at a stage where they are developing self-regulation skills, so teaching them to manage their impulses can help in their overall growth and development. Trust is a critical concept taught during infancy to foster secure attachments. Empathy is crucial for parents of toddlers to understand their child's emotions. Problem-solving skills are typically emphasized for school-age children to enhance cognitive development.

Similar Questions