Fund Prep U

The client reports to the clinic as ordered by the primary care provider for counseling on weight loss to improve overall health. The client received printed information in the mail to review before the session, and reports having read through it before the appointment. Which client statement alerts the nurse to a need for clarification and further education?

"I will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week."

The client is newly diagnosed with type 2 diabetes. After teaching the client about diabetes and how to self-administer insulin, the nurse identifies which client response as a need for additional education?

During the return demonstration, the client draws up insulin, leaving tiny bubbles in the syringe.

A nurse is visiting the home of a first-time mother and her newborn. The nurse is educating the mother about the newborn's sleep needs. The nurse would inform the mother that newborns sleep approximately how many hours per day?

16 to 18 hours

After sedating a client, the nurse assesses that the client is frequently drowsy and drifts off during conversations. What number on the sedation scale would the nurse document for this client?

3

The health care provider has prescribed heat therapy for a client's leg wound. What will the nurse explain to the client about the application of heat therapy?

A 15- to 20-minute application will promote healing and consolidation of pus.

A nurse is caring for a client who has had a left-side mastectomy. The nurse notes an intact Penrose drain. Which statement about Penrose drains is true?

A Penrose drain promotes passive drainage into a dressing.

When preparing client teaching materials, how does the nurse best assess a client's preferred learning style?

Ask the client, "Do you learn best by observing, valuing, or doing?"

When caring for a client at the health care facility, the nurse observes that the client is having difficulty understanding the health education. Which action is most appropriate?

Assess for cultural differences.

How may a nurse demonstrate cultural competence when responding to clients in pain?

Avoid stereotypical responses to pain in clients.

Before starting the education process, the nurse should determine the preferred learning style, age and developmental level, capacity to learn, motivation level, readiness to learn, and learning needs of the client. How does this help the nurse in the client's health education?

By implementing effective teaching

A nurse notices that a toddler is constantly snatching toys from the hands of other preschool children at the health care facility, placing the toddler and other children at risk for injury. What would be a most effective method for teaching the toddler not to snatch toys?

Enlist the aid of the toddler's parents in education.

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 2 hours of bedtime can hinder ability to sleep.

Why is acute pain said to be protective in nature?

It warns an individual of tissue damage or disease.

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

Maintain a calm and quiet environment free from noise.

A client reports severe pain following a mastectomy. The nurse would expect to administer what type of pain medication to this client?

Opioid analgesics

The nurse has provided teaching for a client with a sinus infection who has been prescribed antibiotics and a decongestant. The client states, "I'm not sure how many days I'm supposed to take this antibiotic." What is the nurse's appropriate response?

Reteach the length of time to take the prescription.

A nurse is engaged in primary prevention activities as part of an education plan about heart disease for a client. Which activity would be most appropriate?

explaining the need for regular exercise and stress management

A client reports after a back massage that his lower back pain has decreased from 8 to 3 on the pain scale. What opioid neuromodulator may be responsible for this increased level of comfort?

the release of endorphins

Which response from the client enables the nurse to determine the effectiveness of a recent medication teaching session for an older adult client who is diagnosed with tuberculosis (TB)?

"I will be taking the TB medication for at least 6 months, because it takes a long time to kill the TB germs."

Which documentation example best reflects the complexity of client teaching by the nurse?

"Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."

A nurse notes that a client admitted to a long-term care facility sleeps for an abnormally long time. After researching sleep disorders, the nurse learns that which area of this client's brain may have suffered damage?

Hypothalamus

A client age 61 years has been admitted to a medical unit with a diagnosis of pancreatitis secondary to alcohol use. Which statement by the client suggests that the nurse's teaching has resulted in affective learning?

I'm starting to see how my lifestyle has caused me to end up here."

When a client says, "I don't care if I get better; I have nothing to live for, anyway," which type of counseling would be appropriate?

Motivational counseling

An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in both knees. The nurse knows this client does not want to be a burden on the family, and the client remains stoic despite reporting the pain as severe. The client avoids the topic of surgery and attends church weekly. The client's family is supportive of any decisions the client makes regarding health. Which of the assessment data is most important to forming an individualized education plan for this client concerning treatment for osteoarthritis?

Personal perception of health and aging

A nurse evaluates whether a middle-age client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. What would the nurse most likely use to evaluate the client?

Return demonstration

A client is experiencing difficulty in adjusting to a new prosthesis despite conscientious client education by numerous members of the health care team. How should the team respond to the client's lack of learning to this point?

Revise the education plan that has guided education.

A Chinese client who was previously treated at the health care facility for an open wound has been admitted again because the wound has become gangrenous. It has been identified that the client failed to understand proper wound care. What is the probable reason for the client failing to understand the instruction?

The client belongs to a different culture.

A nurse is educating a client with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the client

The client describes signs and symptoms of hypoglycemia.

A client is worried and states, "I just know I won't be able to sleep before my surgery." What sleeping pattern would the nurse anticipate?

The client will likely not be able to sleep

A parish nurse is preparing to provide a health promotion class to a group of adults in the parish. In preparing to meet the learning needs of this group, the nurse recognizes which as a characteristic of an adult learner?

Their readiness to learn is often related to a developmental task or social role.

The nurse is caring for a 10-year-old client with gastritis. During the health education, which of the following points should the nurse keep in mind with regard to the characteristics of pedagogic learners?

They respond to competition.

For assessment of pain, objective data are used to supplement the subjective data. How can a nurse gather objective data about a client's pain? Select all that apply.

by checking the vital signs by observing facial expressions by eliciting factual information by diagnostic tests and procedures

The nurse is performing an intake assessment of a 60-year-old client who admits to having a nightcap of 4 to 6 ounces of scotch whisky each night. What effect might this alcohol be having on the client's sleep?

decreased REM sleep

Before inserting a urinary catheter, a nurse discusses the procedure with the client. When inserting the catheter, the nurse distracts the client by talking to him about his work. The nurse is attempting to relieve the client's procedural pain through:

focusing on another stimuli in the environment.

A nurse is caring for a client with draining wounds. The nurse needs to apply a dressing of a highly absorbent nature. Which type of dressing should the nurse use for this client?

gauze

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

giving a back massage

A 70-year-old female who is the client's spouse and is learning the care so the client can come home

Which statement describes the person who is likely the most motivated to learn?

The nurse has completed a preoperative teaching session with a client who will receive morphine via a patient-controlled analgesia (PCA) pump after surgery. Which statement by the client indicates the need for further teaching?

"I will remind my family member to push the PCA pump button for me if I doze off during the day."

While caring for a client with chronic pain, the nurse talks with a family member. Which family member statement does the nurse identify as consistent with caregiver role strain?

"Sometimes it seems like I can never get a moment to myself."

The nurse has provided education to a client about home care for an open surgical wound on the lower left extremity. When evaluating learning through the cognitive domain, what statement by the nurse would be appropriate?

"Tell me about what signs of infection you will report to the health care provider."

Which statement is true of chronic pain?

it interferes with normal functioning

A nurse is caring for a client with diabetes and foot gangrene who is scheduled for surgery that involves amputation of the affected foot. What would be most effective in helping the client cope with the fear and pain of surgery?

Explain the surgery and its importance to the client.

The nurse is caring for a client who reports insomnia. The client has recently moved from an area near a fire station in the inner city to the country. Which recommendation will the nurse make to facilitate sleep?

Find a phone app that plays sounds of the city.

Which of the following nonpharmacologic pain relief measures has been found to be effective for soothing agitated newborns and comatose clients?

music

A nurse is reviewing the results of a polysomnogram for a client who is experiencing difficulty sleeping. When looking at the encephalogram component, which wave characteristic would the nurse identify as indicating rapid eye movement sleep?

waves similar to wake state

A nurse is obtaining a sleep history from a client. The client states that he goes to bed at 11:15 pm and is usually asleep by 11:30 pm. The nurse documents this information as reflecting:

sleep latency

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

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

A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggest a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment?

A 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment

Which group of terms best describes sleep?

Altered consciousness, relative inactivity

A cyclist reports to the nurse that he is experiencing pain in the tendons and ligaments of his left leg, and the pain is worse with ambulation. The nurse will document this type of pain as:

Somatic pain

Pet therapy is commonly used in long-term facilities for distraction. If a client is experiencing pain and the pain is temporarily decreased while petting a visiting dog or cat, this is an example of which type of distraction technique?

Tactile kinesthetic distraction

The client is scheduled for a polysomnography to determine if the client has obstructive sleep apnea (OSA). The nurse instructs the client to:

anticipate sleeping overnight at a health care center.

Which factor has the most influence on an individual's sleep-wake patterns?

the inner biologic clock

A client has a severe abdominal injury with damage to the liver and colon from a motorcycle crash. What type of pain will predominate?

visceral pain

Which statement accurately represents a consideration when using an epidural analgesia for client pain management?

The anesthesiologist/pain management team should be notified immediately if the client exhibits a respiratory rate below 10 breaths/min.

A nurse administers pain medication to clients on a med-surg ward. The client that would benefit from a p.r.n. drug regimen as an effective method of pain control would be the client:

in the postoperative stage with occasional pain.

A nurse is caring for a client with cancer who is experiencing pain. What would be the mostappropriate assessment of the client's pain?

the client's pain based on a pain rating

A client reports that her naps after lunch often stretch to 3 hours in length and that she has great difficulty arousing herself after a nap. This condition is best termed as which of the following?

hypersomnia

The nurse talks with a client who states, "My primary care provider wants me to try a TENS unit for my pain. How can electricity decrease my pain?" Which response is most appropriate?

"The mild electrical impulses block the pain signal before it can reach the brain."

A nurse is caring for a client with acute back pain. When should the nurse assess the client's pain?

whenever the vital signs are measured and documented

The nurse is educating a client and spouse about sudden jerking that occurs during sleep. What is the most appropriate nursing response?

"Sudden twitches that occur during the early phases of sleep are common."

A nurse attempts to relieve the pain of a client by using cutaneous stimulation. Which of the following describes usage of this technique?

A nurse applies intermittent heat and cold to a client's leg.

A client has been admitted to a post-surgical unit with a patient-controlled analgesia (PCA) system. Which statement is true of this medication delivery system?

The dose that is delivered when the client activates the machine is preset.

The nurse is providing a massage to a client who has been experiencing muscular pain as a result of overreaching. What actions would the nurse perform to provide comfort for the client? Select all that apply.

Assist the client to the prone position. Begin the massage with light, gliding strokes to shoulders, back and sacral area. End the massage with strokes that are lighter in pre

A nurse instructs a client to tell the nurse about the side effects of a medication. What learning domain is the nurse evaluating?

Cognitive

The parents of a school-age child are meeting with the nurse for health promotional education for their child. The child has the following assessment data: a 7-year-old male with diabetes mellitus type 1 with a hemoglobin A1C level of 8.3%, a body mass index (BMI) of 31.7, and a BMI percentile of 99. What are the most appropriate learning diagnoses for this first session?

Deficient Knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.

A client diagnosed with type 2 diabetes has been prescribed insulin therapy in conjunction with an oral agent because the client has been experiencing difficulty controlling blood sugar levels with an oral agent alone. The nurse is preparing a teaching plan for this client. Which intervention would the nurse include in the teaching plan to address the psychomotor domain?

Demonstrating the technique for insulin self-injection

A nurse is working with an older adult client, educating the client on how to ambulate with the aid of a walker. The nurse notes that the client appears to lack the motivation to learn how to use the device. The client states, "I'm just too old to learn." What would be most appropriate for the nurse to do to motivate this client?

Describe how the walker can improve the client's quality of life.

The nurse is caring for a client who has been admitted for a new diagnosis of hypertension. When should the nurse begin client teaching?

During the admission process

A nurse is preparing to teach a 6-year-old client with a broken arm and the client's mother about caring for the child's cast. Which statement reflects the best education plan for these clients?

Include the child in the education; ask questions of both the mother and the child.

The nurse is conducting a community health promotion class and has developed scenarios that will involve active participation by the class attendees. What type of education strategy is the nurse incorporating into this class?

Role-playing

When a nurse is planning for learning, who must decide who should be included in the learning sessions?

The nurse and the client

The nurse should use extreme caution when applying heat therapy to which of the following clients?

a client who is unconscious

When caring for a client at a health care facility, the nurse discovers that the client is unable to read or write. Which of the following teaching approaches is most useful for the client?

Use verbal and visual modes of communication.

The nurse has been working with a client for several days during the client's recovery from a femoral head fracture. How should a nurse best evaluate whether client education regarding the prevention of falls in the home has been effective?

What changes will you make around your house to reduce the chance of future falls?"

The nurse is visiting a client who was released from inpatient rehabilitation 6 weeks ago after a 5-month recovery from a motor vehicle accident that left the client immobile. As the nurse enters the home, the client braces hands on the arms of a chair to rise and uses crutches to walk across the room. What is the best response by the nurse?

You have made an amazing recovery.

A nurse is performing pain assessments on clients in a physician's office. Which clients would the nurse document as having acute pain? Select all that apply.

a client who is having a myocardial infarction A client who presents with the signs and symptoms of appendicitis A client who fell and broke an ankle

The nurse is assessing clients with common pain sydromes that cause neuropathci pain. Which clients would the nurse identify are at risk for neuropathic pain? Select all that apply.

a client with postherpetic neuralgia a client with phantom limb pain a client with diabetic neuropathy A client with complex regional pain syndrome

The nurse observes that a client responds better to health education when the nurse motivates him and assures him about the benefits of the teaching. In which of the following learning domains does the client's learning style fall?

affective domain

A client with chronic pain uses a machine to monitor his physiologic responses to pain. The unit transforms the data into a visual display and through seeing the pain responses, the client is taught to regulate his physiologic response and control pain through relaxation, imagery, or breathing exercises. This technique for pain control is known as:

biofeedback

The client being seen in the employee wellness clinic reports difficulty sleeping for the past several months. The most important assessment the nurse could make is:

reviewing the client's sleep diary for the past 2 weeks.

The nurse is caring for a client with narcolepsy. The client reports experiencing being unable to move upon awakening from sleep. The client's spouse states that the client makes sandwiches in the middle of the night, yet the client does not recall this behavior. How does the nurse document these concerns?

sleep paralysis and automatic behavior

The nurse is caring for a client with a sacral wound. Upon assessment, the wound is noted to have slough and a bad odor, and it extends into the muscle. How will the nurse categorize this pressure injury?

stage IV

The nurse is caring for a client who is having difficulty sleeping. Which medication does the nurse anticipate will be prescribed by the health care provider?

temazepam

A client is diagnosed with narcolepsy. What is a characteristic of this disorder?

uncontrollable desire to sleep

The nurse makes the following assessment. A middle-age client reports falling asleep frequently at his job during the day, feels like he is not getting enough sleep at night (even though the number of hours of sleep is unchanged), continues to feel tired, and is not able to think clearly. Also, the client reports his wife believes he is irritable upon awakening. Nursing interventions include teaching the client to:

use caution when driving an automobile.

The nurse is caring for a client who demonstrates a health literacy concern. The nurse adjusts client teaching in which way?

uses videos, diagrams, and pictures rather than focusing on verbal teaching

A male college student age 20 years has been experiencing increasingly sharp pain in the right, lower quadrant of his abdomen over the last 12 hours. A visit to the emergency department and subsequent diagnostic testing have resulted in a diagnosis of appendicitis. What category of pain is the client most likely experiencing?

visceral pain

After teaching a group of students about health promotion, disease prevention, and health-protection activities, the instructor determines that the education was successful when the students identify what as a health-protection activity?

water quality regulations