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A client is very anxious before an invasive procedure. What CAM therapy would be most helpful to assist in decreasing anxiety?

Meditation

A client returning to the floor after orthopedic surgery is complaining of nausea. The nurse is aware that an appropriate intervention is to do which of the following?

Avoid strong smelling foods.

In general, how do most people view change?

By how they are affected personally

A nurse is educating a surgical client on postoperative p.r.n. pain control. Which of the following should be included?

"You need to ask for the medication before the pain becomes severe."

A client inquires about the use of herbal therapy. Which statement by the nurse is most accurate?

"Herbs can have side effects and can interact with prescription medications."

A nurse is educating a preoperative client on how to cough effectively. What can the nurse tell the client to do to 18. facilitate coughing?

"Hold a pillow or folded bath blanket over the incision."

A nurse is conducting a health history and asks the client about use of complementary and alternative therapies (CAT) to treat her chronic headaches. What response would require further questions?

"I take herbs to treat my headaches."

In order to prevent the possibility of venous stasis, a nurse is teaching a surgical client how to perform leg exercises. 6. Which of the client's following statements indicates a sound understanding of leg exercises?

"I'll practice these now and try to start them as soon as I can after my surgery."

A client interested in acupuncture asks a nurse, "Just exactly what does it do?" What would the nurse explain?

"It changes the flow of energy and helps healing."

A nurse is teaching a client about the proper use of herbs and supplements. Which statement should be included?

"The product may take a longer time to be effective."

A nurse is educating a client about regional anesthesia. Which of the following statements is accurate about this type of anesthesia?

"You will be awake and will not have sensation of the procedure."

Planned change is a purposeful, systematic effort to alter or bring about change. What occurs next after alternative solutions to a problem are determined and analyzed?

A course of action is chosen from among the alternatives.

A nurse is described as a "quantum leader." Which action characterizes this type of leadership?

A nurse conducts a blind survey to evaluate her leadership skills.

The nurse is a manager on an orthopedic unit. The unit changed to a new computer documentation system three days ago. One of the night nurses has called in sick every shift since the new system started. The nursing manager is aware that this situation has to do with resistance to change. Which of the following are common reasons why people resist change? Choose all that apply.

A) Feel threatened B) Fear increased responsibility C) Lack of understanding D) See no benefits to the change

The nursing student is working to improve his time management. Which of the following would assist the nursing student in accomplishing his goal? Choose all that apply.

A) Identify priorities for the day. B) Evaluate time management at the end of the day. C) Establish a reasonable time line.

A head nurse assumes the leadership role when directing and supervising coworkers. Which of the following are attributes of a leader? Select all that apply.

A) Philosophical C) Charismatic D) Dynamic

A nurse is attempting to change the method for documenting client care in a hospital setting. Which of the following should be considered before planning change? Select all that apply.

A) What is amenable to change? B) How does the group function as a unit? C) Is the group ready for change? D) Are the changes major or minor?

A diabetic client is undergoing surgery to amputate a gangrenous foot. This procedure would be considered which of the following categories of surgery based on purpose?

Ablative

A client with abdominal incisions experiences excruciating pain when he tries to cough. What should the nurse do to reduce the client's discomfort when coughing?

Administer prescribed pain medication 30 minutes before deliberately attempting to cough.

A postoperative home care client has developed thrombophlebitis in her right leg. What category of medications will probably be prescribed for this cardiovascular complication?

Anticoagulants

A nurse is providing ongoing postoperative care to a client who has had knee surgery. The nurse assesses the dressing and finds it saturated with blood. The client is restless and has a rapid pulse. What should the nurse do next?

Apply a pressure dressing and report findings.

A nurse manager makes all of the decisions for staff activities. What type of leadership is demonstrated by this action?

Autocratic

Which of the following is considered a holistic approach to food choices?

Avoid eating foods with preservatives.

A nurse strives to establish trusting interpersonal relationships with clients, peers, subordinates, and superiors to facilitate goal achievement and personal growth of all participants. Which type of skills is this nurse demonstrating?

Communication skills

A woman age 35 years with a chronic disorder tells her nurse that she would be interested in finding out about complementary therapies that are available. What would be the nurse's best response to this client?

Complementary therapies are being used as an 'answer' to the problem of chronic illness.

A nurse is caring for a client who is scheduled to undergo a breast biopsy. Which of the following major tasks does the nurse perform immediately during the pre-operative period?

Conduct a nursing assessment.

A client, scheduled for open-heart surgery, tells the nurse he does not want to be "saved" if he dies during surgery. What should the nurse do next?

Discuss with and document the wishes of the client and family

There are four primary scientific principles for therapeutic touch. Which of the following is not one of these principles?

Distractions of modern life interfere with healing agents.

A nurse is reviewing results of preoperative screening tests and notes the client's potassium level is dangerously low. What should the nurse do next?

Document the data and notify the physician who will do the surgery.

The imbalance of which of the following can by the result of stress, lifestyle, and improper diet?

Doshas

A student is assessing a postoperative client who has developed pneumonia. The plan of care includes positioning the client in the Fowler's or semi-Fowler's position. What is the rationale for this position?

It promotes full aeration of the lungs.

Upon assessment, a client reports that he drinks five to six bottles of beer every evening after work. Based upon this information, the nurse is aware that the client may require which of the following?

Larger doses of anesthetic agents and larger doses of postoperative analgesics

Which of the following statements accurately describes recommended guidelines for overcoming resistance to change? Select all that apply.

List the advantages of the proposed change for members of the group. If possible, introduce change gradually.

A nurse is practicing imagery to relieve stress. What might accompany the imagery to even further promote relaxation?

Listening to music

After conducting a preoperative health assessment, the nurse documents that the client has physical assessments supporting the medical diagnosis of emphysema. Based on this finding, what postoperative interventions would be included on the plan of care?

Monitor respirations and breath sounds.

A nurse is taking care of a client during the immediate post-operative period. Which of the following duties performed during the immediate post-operative period is most important?

Monitor the client for complications.

A young mother experiences nausea and diarrhea when stressed. What mind-body messenger is believed to be responsible for these responses?

Neuropeptides

A student nurse has just graduated with a baccalaureate degree in nursing. What type of nursing leadership will this nurse be expected to provide?

Nursing care of the individual client

A preoperative assessment finds a client to be 75 pounds overweight. The client is to have abdominal surgery. What nursing diagnosis would be appropriate based on the client's weight?

Risk for Infection

Nurses with varying levels of experience possess leadership skills. A graduate nurse walks out of the nurse manager's office after a meeting. The graduate nurse reflects on the positive and negative feedback that she received from the manager regarding her three months working on the unit. What nursing leadership skill is best illustrated by the graduate nurse in this scenario?

Self-evaluation skills

What philosophy underlies the use of CAT?

The mind, body, and spirit function as a unified whole.

In Lewin's classic theory of change, what happens during unfreezing?

The need for change is recognized.

A trained nurse uses the technique of "Rolfing" to break up tension in client body structures. What type of CAT is being used by this nurse?

Therapeutic massage

Which of the following statements accurately describes the use of power by change agents?

They are often accomplished professional women.

A young woman has been in an automobile crash that resulted in an amputation of her left lower leg. She verbalizes grief and loss. What knowledge by the nurse is used to provide interventions to help the client cope?

This is a normal, appropriate response.

A nurse working in a PACU is responsible for conducting assessments on immediate postoperative clients. What is the purpose of these assessments?

To prevent complications from anesthesia and surgery

A Native American client informs the nurse that she practices shamanism. The nurse is aware that shamanism is best 3. described as which of the following?

Use of general healing techniques that involve plants, herbs, animals, ritual, ceremony, and purification by a medicine man or woman

Which of the following nursing interventions occurs in the postoperative phase of the surgical experience?

Airway/oxygen therapy/pulse oximetry

A nurse working on leadership skills should keep in mind which of the following accurate statements regarding leaders?

All nurse leaders began as inexperienced nurses.

The nurse has just graduated with a Bachelor of Science in Nursing and is eager to find a mentor at this early stage in her career. Which of the following individuals is most likely to be an appropriate mentor for the nurse?

An experienced nurse who was a preceptor in a previous clinical placement

A physician has ordered a nurse to administer conscious sedation to a client. Which of the following is possible after administering conscious sedation to a client?

Client is relaxed, emotionally comfortable, and conscious.

A client with rheumatoid arthritis complains of soreness in his joints. Which of the following homeopathic remedies 7. might the nurse recommend for this client?

Arnica

A nurse is assisting a postoperative client with deep-breathing exercises. Which of the following is an accurate step for this procedure?

Ask the client to hold his or her breath for three to five seconds and mentally count "one, one thousand, two, on thousand" and so forth.

Which of the following interventions are recommended guidelines for meeting client postoperative elimination needs?

Assess for the return of peristalsis by auscultating bowel sounds every four hours when the client is awake.

The nurse is providing education to a client regarding pain control after surgery. What time does the nurse inform the client is the best time to request pain medication?

Before the pain becomes severe

A client informs a nurse practitioner that she takes the herb St. John's wort for symptoms of depression. The nurse recognizes herbal therapy as belonging to which complementary and alternative therapy (CAT) domain?

Biologically based practices

What type of leader shares decisions and activities with group participants?

Democratic

What type of leadership can a graduate nurse working in a magnet hospital expect?

Democratic

During a staff meeting, the nurse is discussing new quantum leadership. The nurse explains that in this type of leadership change is viewed as which of the following?

Dynamic and constantly unfolding

A female client is scheduled for liposuction surgery to reduce her weight. Based on urgency, how is this surgery classified?

Elective

The nurse is having an exceptionally busy shift on an obstetrical unit. Which of the following tasks is the nurse justified in delegating to an unlicensed care provider?

Emptying a client's Foley catheter bag and reporting the volume to the nurse

A nurse manager has encountered resistance to a planned change. What is one way the nurse can overcome the resistance?

Encourage open communication and feedback.

Which statement accurately represents a recommended guideline when providing postoperative care for the following clients?

If vital signs are progressively increasing or decreasing from baseline, notify the physician of possible internal bleeding.

A nurse uses Therapeutic Touch to decrease a postoperative client's nausea. Which of the following is a principle of this CAT modality?

Illness is an imbalance in a person's energy field.

Which of the following would be the least consistent as a reason for the use of complementary and alternative medicine (CAM)?

Increasing numbers of acute conditions

A nurse is considering the delegation of administering medications to an unskilled assistant. What is the first question the nurse must ask herself before doing so?

Is the delegated task permitted by law?

A nurse is assisting a physician during a cesarean section for a client. The client is administered epidural anesthesia. Which of the following is an advantage of epidural anesthesia?

It decreases the risk of gastrointestinal complications.

An operating room nurse is preparing for a surgical procedure on an infant. The nurse's perioperative care is based on what physiologic factor that puts infants at greater risk from surgery than adults?

Lower total blood volume

A cleansing enema is ordered for a client who is scheduled to have colon surgery. What is the rationale for this procedure?

Peristalsis does not return for 24 to 48 hours after surgery.

Which of the following considerations should a nurse prioritize surrounding the use of herbs and supplements by a client?

Potential interactions with drugs

A client scheduled for major surgery will receive general anesthesia. Why is inhalation anesthesia often used to provide 8. the desired actions?

Rapid excretion and reversal of effects

What is the ultimate goal of increasing the parasympathetic system influence on the body through relaxation or meditation?

Reduce the effects of stress on the body

A nurse has been asked to ensure informed consent for a surgical procedure. What might be a role of the nurse?

Signing the consent form as a witness

In which of the following conflict resolution strategies is the conflict rarely resolved?

Smoothing

Why is it important to obtain information from a client related to the use of herbal supplements during a nursing 2. assessment?

Some herbs or supplements may interact with a client's prescribed medications.

When comparing team nursing with functional nursing, what characteristic is found?

Team nursing focuses on individual client care.

Which type of skills is not needed for nursing leadership?

Technical skills

A nurse practices holistic client care. Which of the following is a guiding principle of this practice?

The body is a unified, dynamic whole.

Which of the following interventions is of major importance during preoperative education?

Which of the following interventions is of major importance during preoperative education?

Which of the following nursing care tasks is acceptable for a graduate nurse to delegate to unlicensed assistive personnel (UAP)?

Which of the following nursing care tasks is acceptable for a graduate nurse to delegate to unlicensed assistive personnel 1. (UAP)?

Which of the following populations are more inclined to use CAT? Select all that apply.

Women, former smokers

The nurse is providing information about warfarin (Coumadin) to a client who takes herbal products. The nurse states, "Some herbs interfere with the effectiveness of warfarin. Do you take ...

ginkgo biloba?"

The client is a male who states his wife complains that his snoring awakens her at night. The spouse is present. To obtain further data, the nurse asks the spouse what?

"Is there silence after snoring which then is followed with a snort?"

A client in his 40s has asked the nurse how much sleep he should be getting in order to maximize his health and well-being. How should the nurse respond?

"Most adults need between seven and nine hours, but everyone is different."

Which of the following clients likely faces a risk for the nursing diagnosis of Disturbed Sleep Pattern: Difficulty Remaining Asleep?

A client who receives IV antibiotics every three hours

A client has sought care because of insomnia that has been increasing in severity and frequency in recent months. What questions should the nurse include in an assessment of this client's health problem? Select all that apply.

A) "Do you have a family history of sleep disturbances?" B) "Do you smoke?" C) "What medications are you currently taking?" D) "Do you have a consistent routine around getting ready for bed and going to bed?"

Which group of terms best describes sleep?

Altered consciousness, relative inactivity

Which medication is least likely to affect sleep quality?

Ambien

A nurse is caring for a client diagnosed with sleep apnea. What should the nurse do in order to promote sleep in the client?

Avoid sedatives for sleeping.

A client is diagnosed with narcolepsy. Which of the following is a characteristic of this disorder?

Uncontrollable desire to sleep

A client who has a sleep disorder is trying stimulus control to improve amount and quality of sleep. What is recommended in this type of therapy?

Use the bedroom for sleep and sex only.

A nurse is caring for a client who complains about sleep apnea. Which of the following delivery devices should the nurse use to administer oxygen to this client?

CPAP mask

What name is given to the rhythmic biologic clock that exists in humans?

Circadian rhythm

Which of the following tasks could the nurse safely delegate to unlicensed assistive personnel?

Documentation of client's I+O on a flow sheet

A middle-age adult man has just started an exercise program. What would the nurse teach him about timing of exercise and sleep?

Exercising within two hours of bedtime can hinder ability to sleep

What independent nursing action can be used to facilitate sleep in hospitalized clients who are on bedrest?

Giving a back massage

Which of the following is a theory and philosophy that focuses on connections and interactions between parts of the whole?

Holism

Which of the following complementary and alternative therapies is based on the "Law of Minimal Dose"?

Homeopathy

A client reports that her naps after lunch often stretch to three hours in length and that she has great difficulty rousing herself after a nap. This condition is best termed as which of the following?

Hypersomnia

A nurse is caring for a client who is sleeping for abnormally long periods of time. This condition may be caused by injury to which of the following body structures?

Hypothalamus

Which expected outcome demonstrates the effectiveness of a plan of care to promote rest and sleep?

Identifies factors that interfere with normal sleep pattern

A nurse working the night shift assesses a client's vital signs at 4 a.m. (0340). What would be the expected findings, based on knowledge of NREM sleep?

Increased TPR and BP

The nurse is preparing to send a client to the operating room for an exploratory laparoscopy. The nurse recognizes that there is no informed consent for the procedure on the client's chart. The nurse informs the physician who is performing the procedure. The physician asks the nurse to obtain the informed consent signature from the client. What is the nurse's best action to the physician's request?

Inform the physician that it is his or her responsibility to obtain the signature.

Which of the following is the most common sleep disorder?

Insomnia

A sedative-hypnotic has been prescribed to help a client sleep. What should the nurse teach the client about this medication?

It loses its effectiveness after one or two weeks

A nurse is caring for a client who has been diagnosed with insomnia. What nursing intervention would help the nurse relieve the client's condition?

Maintain a calm and quiet environment free from noise.

Based on the circadian cycle, the body prepares for sleep at night by decreasing the body temperature and releasing which chemical?

Melatonin

Which natural chemical does the body produce at night to decrease wakefulness and promote sleep?

Melatonin

What condition have studies confirmed occurs when adults and children do not get recommended hours of sleep at 25. night?

Obesity

What is the most common method for ordering sleep medications?

PRN

What is the rationale for using CPAP to treat sleep apnea?

Positive air pressure holds the airway open.

The nurse manager in an acute care facility has received client evaluations in which the clients have complained about excessive noise that interfered with their rest. The nurse manager and nursing staff plan to do the following. Which activity will most assist clients in obtaining rest?

Post signs for quiet and turn down hall lights during formal quiet times.

A nurse educates a young couple on putting their newborn on his back to sleep. What is the rationale for this information?

Prone position increases the risk for sudden infant death syndrome.

Which drug normalizes sleep cycles by enabling the body's supply of melatonin to naturally promote sleep?

Ramelteon (Rozerem)

The parents of a boy 10 years of age are worried about his sleepwalking (somnambulism). What topic should the nurse discuss with the parents?

Safety

An individual awakens from a sound sleep in the middle of the night because of abdominal pain. Why does this happen?

Stimuli from peripheral organs to the RAS

A client with a sleep disorder experiences cataplexy. Which is a feature of this condition?

Sudden loss of motor tone that may cause the person to fall asleep; usually experienced during a period of strong emotion

Which of the following guidelines does the nurse apply to discussion of sleep patterns with older adult clients?

Total sleep time decreases as the clients age.

A client's bed partner reports the client often has irregular snoring and silence followed by a snort. Does this warrant further assessment?

Yes, this is an indicator of obstructive apnea

Which individual is likely to require more hours of sleep?

a person 15 years of age

A nurse practitioner uses integrative care in his practice. What does this mean?

He uses both allopathic medicine and CAT.

The nurse is caring for a client who had a sudden episode of vomiting, which produced 900 mL of frank blood. The nurse directed and delegated to colleagues in order to notify the physician. She started intravenous fluids, and provided physical and emotional support for the client. Different situations call for different leadership styles. Which of the following leadership styles did the nurse display in this situation?

Autocratic

The telemetry unit nurse is reviewing laboratory results for a client who is scheduled for an operative procedure later in the day. The nurse notes on the laboratory report that the client has a serum potassium level of 6.5 mEq/L, indicative of hyperkalemia. The nurse informs the physician of this laboratory result because the nurse recognizes hyperkalemia increases the client's operative risk for which of the following?

Cardiac problems

A nurse believes in listening to clients and coworkers more than talking to them, allowing more personal control for all involved. This is a quality of which of the following managerial mindsets?

Collaborative

A senior student has been elected president of the Student Nurses Association. Which of the following qualities is essential to being a nursing leader?

Flexibility

A nurse manager has directed a registered nurse who is out of school for one year to become a member of the institution's policy and procedure committee. A goal in the nurse manager's delegation is to assist the nurse to what?

Grow in her profession

A nurse is using a technique that involves the five senses to visualize recovering from an upcoming surgical procedure. 1. What type of technique is the nurse teaching the client to use?

Guided imagery

Which of the following is a characteristic of mentorship?

It is a link to a protégé with common interests.

The ANA, which is committed to monitoring the regulation, education, and use of NAPs, recommends adherence to which one of the following principles?

It is the nursing profession that determines the scope of nursing practice.

A nurse in an outpatient surgical center is teaching a client about what will be necessary for discharge to home. What information should the nurse include about transportation?

The client is not allowed to drive a car home.

The client is postoperative. The nurse is practicing healing touch with the client. Which of the following would the nurse evaluate as an expected outcome of healing touch?

The client states that his anxiety following surgery has decreased.

A nurse who is a traditional Chinese medicine practitioner is providing home care to a client who also uses traditional Chinese medicine for health care. What specific assessments would the nurse make?

Tongue and pulses

A nurse leader is described as charismatic, motivational, and passionate. Communications are open and honest, and the 11. nurse is willing to take risks. What type of leadership is the nurse practicing?

Transformational

A client is taking ginkgo to improve her memory. In the education plan regarding this herb, the nurse should include which of the following?

Use caution if taking aspirin.


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