Level 2 Final Discussion Board
A client who had lithotripsy for a renal calculus is to be discharged from the hospital. The nurse who is providing home care instructions should include: A. Drinking at least 3L of fluid daily for 4 weeks B. Removing organ meats from the diet for 6 weeks C. Increasing the intake of dairy products for 5 days D. Restricting movement for 3 days before resuming activities
A?
A 76-year-old client is admitted with the diagnosis of mild chronic heart failure. The sounds indicative of chronic heart failure that the nurse expects to hear when listening to the client's lungs are: A. Stridor B. Crackles C. Wheezes D. Friction rubs
B
A client is scheduled for surgery. Legally, the client may not sign the operative consent if: A. Ambivalent feelings are present and acknowledged. B. Any sedative type of medication has recently been given. C. A discussion of alternatives with two physicians has not occurred. D. A complete history and physical has not been performed and recorded.
A
A state nurse's practice act does not allow a registered nurse (RN) to suture wounds. The practitioner offers to teach the RN how to suture and tells the RN that minor wounds may be sutured without supervision. The nurse should: A. Refuse to suture the wounds B. Follow the practitioner's instructions C. Report the situation to the state board of nursing D. Agree to suture wounds in the practitioner's presence
A
When planning the discharge teaching for a client who had an ileostomy, the nurse places primary emphasis on: A. Informing the client about the ileostomy association B. Telling the client whom to contact if assistance is needed C. Encouraging the client to return to the workplace as soon as possible D. Teaching the client the importance of irrigations to regulate bowel movements
B*
A day after an explanation of the effects of surgery to create an ileostomy, a 68-year-old male client remarks to the nurse, "It will be difficult for my wife to care for a helpless old man." This comment by the client regarding himself is an example of Erikson's conflict of: A. Initiative vs guilt B. Integrity vs despair C. Industry vs inferiority D. Generativity vs stagnation
B: According to Erikson, poor self-concept and feelings of despair are conflicts manifested in those who are older than 65 years of age. The initiative versus guilt conflict is manifested in early childhood between 3 and 6 years of age. The industry versus inferiority conflict is manifested during the ages from 6 to 11 years. The generatively versus stagnation conflict is manifested during middle adulthood, 45 to 65 years of age.
A 90-year-old female resident of a nursing home falls and fractures the proximal end of her right femur. The surgeon plans to reduce the fracture with an internal fixation device. The general fact about the older adult that the nurse should consider when caring for this client is that: A. Aging causes a lower pain threshold B. Physiological coping defenses are reduced C. Most confusional states result from dementia D. Older adults psychologically tolerate changes well
B?
Which statement by the nursing assistant indicates a correct understanding of the nursing assistant role? A. "I will turn off clients' IVs that have infiltrated." B. "I will take clients' vital signs after their procedures are over." C. "I will use unit written materials to teach clients before surgery." D. "I will help by giving medications to clients who are slow in taking pills."
B?
Polycythemia is frequently associated with chronic obstructive pulmonary disease (COPD). When assessing for this complication, the nurse should monitor for: A. Pallor and cyanosis B. Dyspnea on exertion C. Elevated hemoglobin D. Decreased hematocrit
C
The fetus of a client in labor is in the left occiput posterior (LOP) position. What should the nurse advise the client's partner to do to alleviate some of the discomfort caused by this type of labor? A. Encourage the client to sleep whenever possible B. Instruct the client to take deeper breaths during contractions C. Apply pressure to the client's sacral area during a contraction D. Elevate the head of the client's bed to a semi-Fowler position
C
The left foot of a client with a history of intermittent claudication becomes increasingly cyanotic and numb. Gangrene of the left foot is diagnosed, and because of the high level of arterial insufficiency, an above-the-knee amputation is scheduled. The response that demonstrates emotional readiness for the surgery is when the client: A. Explains the goals of the procedure B. Displays few signs of anticipatory grief C. Participates in learning perioperative care D. Verbalizes acceptance of future dependency needs
C
The nurse explains to a client that a positive diagnosis for HIV infection is made based on: A. Positive ELISA and Western blot tests B. Performance of high-risk sexual behaviors C. Evidence of extreme weight loss and high fever D. Identification of an associated opportunistic infection
D?
An 80-year-old female is admitted to the hospital because of complications associated with dehydration. The client's daughter asks the nurse how her mother could have become dehydrated because she is alert and able to care for herself. The nurse's best response is: A. "The body's fluid needs decrease with age because of tissue changes." B. "Access to fluid may be insufficient to meet the daily needs of the older adult." C. "Memory declines with age, and the older adult may forget to ingest adequate amounts of fluid." D. "The thirst reflex diminishes with age, and therefore the recognition of the need for fluid is decreased."
D
When meeting the unique preoperative teaching needs of an older adult, the nurse plans a teaching program based on the principle that learning: A. Reduces general anxiety B. Is negatively affected by aging C. Requires continued reinforcement D. Necessitates readiness of the learner
D