RNSG 1125 Patient- Centered Care

The nurse is teaching the Crede maneuver to a client who has difficulty urinating. Which nursing teaching is appropriate?

"Bend forward and apply pressure over your bladder."

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?

Care-based ethics

A 15-year-old client who is 26 weeks pregnant has been admitted to the labor and delivery unit with reports of abdominal pain. Her parents want to speak with a nurse about her condition. How should the nurse respond?

"I'll need a signed consent from your daughter to give you medical information."

A patient's family member asks the nurse what the purpose of hospice is. What is the best response by the nurse?

"It will enable the patient to remain home if that is what is desired." SUBMIT ANSWER

The nurse has entered the room of a client who is postoperative day 1 and finds the client grimacing and guarding her incision. The client refuses the nurse's offer of PRN analgesia and, on discussion, states that this refusal is motivated by his fear of becoming addicted to pain medications. How should the nurse respond to the client's concerns?

"Research has shown that there is very little risk of clients becoming addicted to painkillers after they have surgery."

A nurse is preparing a client for a lumbar puncture. The client has heard about post-lumbar puncture headaches and asks what causes them. The nurse tells the client that these headaches are caused by which of the following?

Cerebral spinal fluid leakage at the puncture site

A client asks what trochanter rolls are used for when providing client care. What is the appropriate nursing response?

"To prevent your legs from rotating outward."

A client diagnosed with thyroid cancer signed a living will that states the client doesn't want ventilatory support if the condition deteriorates. As the client's condition worsens, the client states, "I changed my mind. I want everything done for me." Which response by the nurse is best?

"What exactly do you mean by wanting 'everything' done for you?"

When describing the role of the various members of the rehabilitation team, which member would the nurse identify as the one who determines the final outcome of the process?

Patient

What is a key element of providing family-centered care?

Communicate specific health information.

A major role for nursing in the management of glaucoma is health education. Which of the following is the most important teaching point that the nurse should advise the patient of?

Adhere to the medication regimen.

A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client?

Administering morphine I.V. as ordered

The nurse is aware that burr holes may be used in neurosurgical procedures. Which of the following is a reason why a neurosurgeon may choose to create a burr hole in a patient?

Aspiration of a brain abscess

What is the priority intervention for a client who has been admitted repeatedly with attacks of gout?

Assess diet and activity at home

The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do first?

Assess the client.

A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?

Autonomy

Which method would the nurse use to identify the educational needs of clients in a senior center?

Conduct focus group interviews and have the clients fill out a survey.

The nurse in the preoperative setting is preparing the client for surgery. During completion of the preoperative checklist the client states, "I have a question about my surgery." What is the next action by the nurse?

Contact the surgeon to answer the client's question.

Sixty to eighty percent of pancreatic tumors occur in the head of the pancreas. Tumors in this region obstruct the common bile duct. Which of the following clinical manifestations would indicate a common bile duct obstruction associated with a tumor in the head of the pancreas? Choose all that apply.

Dark urine Clay- colored stools Pruritis Jaundice

If a client has a lower motor neuron lesion, the nurse would expect to observe which manifestation upon physical assessment?

Decreased muscle tone

As part of HAART therapy, a client is prescribed a non-nucleoside reverse transcriptase inhibitor (NNRTI). What would be an example of a drug from this class? Select all that apply.

Delavirdine Efavirenz

The nurse is performing an initial assessment of a client with a disability. The nurse should assess for which condition? Select all that apply.

Depression Abuse

A client with cancer-related pain has been prescribed a narcotic analgesic to be given around the clock. The client is competent and has been actively involved in decisions regarding care. What should the nurse do if the client refuses the next dose of analgesia?

Document the client's choice and re-assess pain in 1 hour.

Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels?

Frequent vomiting, leading to loss of fluid volume

An anxious client being prepared for surgery is encouraged to concentrate on a pleasant experience or restful scene. What cognitive coping strategy would the nurse document as being used?

Imagery

Which is a cause related to the increasing number of people with chronic conditions?

Improved screening and diagnostic procedures

A current trend in health education that significantly influences nursing practice is:

Increased emphasis on patient involvement in their own care.

Which model of disability is the most appropriate for use by nurses to provide care that empowers clients?

Interface model

The nurse is caring for a client who is scheduled for a transesophageal echocardiogram. What nursing intervention is a priority after the procedure?

Keep the head of the bed elevated 45 degrees and keep NPO until return of the gag reflex.

The preferred preparation for treating hypothyroidism includes which of the following?

Levothyroxine (Synthroid)

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 is documenting the eating habits of a client who wants to include more fiber in the diet. Which is the best statement to include?

Plans to eat a snack of fruit twice per day.

Which statement accurately reflects the prognosis for a client with a personality disorder?

Prognosis varies based on the degree of functional impairment and the client's motivation to change.

When a person authorizes another to make medical decisions on his or her behalf, the person has written which of the following?

Proxy directive

During which phase of the Trajectory Model of chronic illness is the focus of nursing care on reinforcing positive behaviors and offering ongoing monitoring?

S

Following a generalized seizure in a client, which nursing assessment is a priority for detailing the event?

Seizure was 1 minute in duration including tonic-clonic activity.

A nurse is providing care for clients in a long-term care facility. What should be the central focus of this care?

The client receiving the care

A nurse is providing teaching to clients in a short-term rehabilitation facility. Which examples are common teaching mistakes made by health care professionals? Select all that apply.

The nurse ignores the restrictions of the client's environment. The nurse uses medical jargon frequently when discussing the teaching plan. The nurse fails to accept that clients have the right to change their minds.

The nurse is caring for a client who just learned of his terminal diagnosis. After the physician leaves, the nurse remains to answer further questions so that the client can make an informed decision about further treatment. By providing all available information, the nurse is promoting which ethical principle?

The principle of autonomy

Which finding indicates increasing intracranial pressure (ICP) in the client who has sustained a head injury?

Widened pulse pressure

A nurse is providing care to a client confined to bed. To promote independence while the client is moving in bed and provide the client assistance in moving up in bed, which device would be appropriate?

bed trapeze

A nurse is caring for a client who has a history of a cerebral aneurysm. Which diagnostic test does the nurse anticipate to monitor the status of the aneurysm?

cerebral angiography

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?

pituitary disorder

A woman is lightly stroking her abdomen in rhythm with her breathing during contractions. The nurse identifies this technique as:

effleurage

On discharge, a client who underwent left modified radical mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she:

should continue to perform breast self-examination on her right breast.

A mentally incapacitated client is scheduled for surgery. Considering the principle of autonomy, who should give the consent for surgery?

surrogate decision maker

A client who has a lengthy history of progressive hearing loss is very forthright about the condition, and the nurse wants to develop a communication strategy for this client's hospital stay. Which communication strategy has proven to be the most effective?

the one the client will use