EAQ 1 - Communication

When conducting a client interview, which nurse's response is an example of back channeling? A. "All right, go on... " B. "What else is bothering you?" C. "Tell me what brought you here." D. "How would you rate your pain on a scale of 0 to 10?"

A. "All right, go on... "

Which instruction about phenytoin will the nurse provide during discharge teaching to a client with epilepsy who is prescribed phenytoin for seizure control? A. "Antiseizure medications will probably be continued for life." B. Phenytoin prevents any further occurrence of seizures." C. "This medication needs to be taken during periods of emotional stress." D. Your antiseizure medication usually can be stopped after a year's absence of seizures."

A. "Antiseizure medications will probably be continued for life."

Which statement by an adolescent about sickle cell anemia would cause the nurse to conclude that the teaching has been understood? A. "I'll start to have symptoms when I drink less fluid." B. "I'll start to have symptoms when I have fewer platelets." C. "I'll start to have symptoms when I decrease the iron in my diet." D. "I'll start to have symptoms when I have fewer white blood cells."

A. "I'll start to have symptoms when I drink less fluids."

How would a nurse respond to the spouse of a client with an intracranial hemorrhage who asks the nurse, "Why aren't they administering an anticoagulant?"? A. "It is not advisable because bleeding will increase." B. "If necessary, it will be started to enhance circulation." C. "If necessary, it will be started to prevent pulmonary thrombosis." D. "It is inadvisable because it masks the effects of the hemorrhage."

A. "It is not advisable because bleeding will increase."

Which statement by a new mother observing her preterm infant in the neonatal intensive care nursery indicates that she has not yet begun the bonding process? A. "It's such a tiny baby." B. "Do you think he'll make it?" C. "Why does he need to be in an incubator?" D. "My baby looks so much like my husband."

A. "It's such a tiny baby."

Which is the nurse's most therapeutic response for the child who is about to have an intravenous (IV) line inserted and cries out that he is afraid of IVs? A. "Tell me what frightens you." B. "It's just a little prick in the arm." C. "You're a big boy; this will hardly hurt." D. "Come on—there's no reason to be afraid."

A. "Tell me what frightens you."

Within which period of time would a nurse advise the client to anticipate pain relief will begin when nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina? A. 1-3 minutes B. 4-5 seconds C. 30-45 seconds D. 10-15 minutes

A. 1-3 minutes

Which information would the nurse include in explaining glaucoma to a client? A. An increase in the pressure within the eyeball B. An opacity of the crystalline lens or its capsule C. A curvature of the cornea that becomes unequal D. A separation of the neural retina from the pigmented retina

A. An increase in the pressure within the eyeball

Which action would the nurse take after contacting the primary health care provider of a post-surgical client complaining of nausea, fatigue, and a headache during the fourth hour of the infusion of total parenteral nutrition (TPN) instituted via a central venous infusion who has an hourly urine output that is twice the amount of the previous hour? A. Check the serum glucose level. B. Obtain an oxygen saturation level. C. Administer a prescribed analgesic. D. Elevate the head of the bed.

A. Check the serum glucose level.

Which therapeutic response would the nurse provide to the parents of an adolescent treated for allergies who privately tell the nurse that they suspect that their child is a hypochondriac? A. Discussing developmental behaviors of adolescents B. Explaining potentially serious complications of allergies C. Discussing some of the underlying causes of hypochondriasis D. Explaining that the parents may be transferring their fears to their adolescent

A. Discussing developmental behaviors of adolescents

Which information would the nurse focus on when teaching a high school student about scoliosis treatment options? A. Effect on body image B. Least invasive treatment C. Continuation with schooling D. Maintenance of contact with peers

A. Effect on body image

Which characteristic is most essential for the nurse to have in caring for clients with mental health disorders? A. Empathy B. Sympathy C. Organization D. Authoritarianism

A. Empathy

Which action would the nurse take in a client who takes rifampin who tells the nurse, "My urine looks orange."? A. Explain that this is normal B. Check the liver enzymes C. Ask the provider to order a urinalysis D. Ask what foods were eaten

A. Explain that this is normal

A client does not take their medication regularly and is depressed. Which inference can the nurse make about the client's motivational level? A. Not motivated B. Intrinsically motivated C. Extrinsically motivated with self-determination D. Extrinsically motivated without self-determination

A. Not motivated

Which consistent approach would the nurse use for a client diagnosed with an antisocial personality disorder? A. Warm and firm without being punitive B. Indifferent and detached but nonjudgmental C. Conditionally acquiescent to client demands D. Clearly communicative of personal disapproval

A. Warm and firm without being punitive

Which explanation will the nurse give when a client asks about what causes varicose veins? A. "Abnormal configurations of the veins." B. "Incompetent valves of superficial veins." C. "Decreased pressure within the deep veins." D. "Atherosclerotic plaque formation in the veins."

B. "Incompetent valves of superficial veins."

Which response would a nurse give to a client who asks "Why can't I take the insulin in pills instead of taking shots?" during a teaching session about insulin injections? A. "Insulin cannot be manufactured in pill form." B. "Insulin is destroyed by gastric juices, rendering it ineffective." C. "Your health care provider decides the route of administration." D. "Your health care provider will prescribe pills when you are ready."

B. "Insulin is destroyed by gastric juices, rendering it ineffective."

A mother whose son has acute glomerulonephritis (AGN) is fearful that her other children may contract the disorder. Which response would the nurse tell the mother about the origin of AGN? A. "The disorder is difficult to prevent because the cause is unknown." B. "It is a result of an autoimmune response after a streptococcal infection." C. "It is transmitted through a sex-linked chromosome that occurs only in males." D. "The disorder is caused by clot formation in the kidney tubules as a response to an infection."

B. "It is a result of an autoimmune response after a streptococcal infection."

After surgery, an adolescent has a patient-controlled analgesia (PCA) pump that is set to allow morphine delivery every 6 minutes. Which statement indicates to the nurse that the family understand instructions about the PCA pump? A. "I'll make sure that she pushes the PCA button every 6 minutes." B. "She needs to push the PCA button whenever she needs pain medication." C. "I'll have to wake her up on a regular basis so she can push the PCA button." D. "I'll press the PCA button every 6 minutes so she gets enough pain medication while she's sleeping."

B. "She needs to push the PCA button whenever she needs pain medication."

Which response would the nurse make to a client who says, "I feel so guilty. None of this makes any sense. Everyone must really think I'm crazy," after performing a complex ritual? A. "Your behavior is bizarre, but it serves a useful purpose." B. "You're concerned about what other people are thinking about you." C. "I am sure people understand that you can't help this behavior right now." D. "Guilt serves no useful purpose. It just helps you stay stuck where you are."

B. "You're concerned about what other people are thinking about you."

Which explanation, when providing a change-of-shift report, would the nurse use to describe a client diagnosed with schizophrenia who is experiencing opposing emotions simultaneously? A. Double bind B. Ambivalence C. Loose association D. Inappropriate affect

B. Ambivalence

The nurse is caring for a 9-month-old infant with gluten-induced enteropathy. Which common term for this disorder would the nurse use when discussing the infant's diagnosis with the parents? A. Megacolon B. Celiac disease C. Cystic fibrosis D. Intussusception

B. Celiac disease

Which statement explains why are so many drugs are necessary for a client with stage III Hodgkin's disease who is started on a multiple-drug regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine? A. Using smaller doses of several drugs reduces the likelihood of serious side effects. B. Each drug destroys the cancer cell at a different time in the cell cycle. C. Several drugs are used to destroy cells that are not susceptible to radiation therapy. D. Because there are stages of Hodgkin's disease, if one drug is ineffective, another will work.

B. Each drug destroys the cancer cell at a different time in the cell cycle.

The parent of a child with a terminal illness appears overwhelmed and anxious. Which is the best response by the nurse? A. Explaining the diagnosis in a variety of ways B. Encouraging the parent to express their feelings C. Recommending that the parent talk with other parents D. Offering assurance that surgery will probably correct the problem

B. Encouraging the parent to express their feelings

Which type of delusion would the nurse chart about a client who says, "I've figured out how foreign agents have infiltrated the news media. Now they want to shut me up"? A. Nihilistic B. Persecution C. Control D. Grandeur

B. Persecution

Morning sickness generally disappears by the end of which month? A. Fifth month B. Third month C. Fourth month D. Second month

B. Third month

An adult client with low-functioning Down syndrome (trisomy 21) appears in the emergency department via ambulance after an accident. Which assessment method would be the best instrument to use when determining this client's level of pain? A. Asking the client's parent B. Using the Wong-Baker FACES Pain Rating Scale C. Observing the client's body language D. Explaining and using the 0 to 10 pain scale

B. Using the Wong-Baker FACES Pain Rating Scale

Which response would the nurse provide the parent of a 2-year-old child who asks, "Why did you have my child draw on paper when they don't draw at home"? A. "I should have asked you about drawing first." B. "These drawings help us determine your child's intelligence." C. "It lets us test the child's ability to perform tasks requiring the hands." D. "I don't understand why drawing is forbidden in your home."

C. "It lets us test the child's ability to perform tasks requiring the hands."

An 8-year-old child has experienced the death of a sister. The child begins to ask many questions about what happens to the body after death. The parent asks whether this is abnormal or morbid behavior picked up from playing video games. Which is the best response by the nurse? A. "Playing video games can cause morbid behaviors." B. "Children handle the event of death more realistically than adults do." C. "School-aged children are inquisitive and ask a lot of questions about death." D. "Giggling, attracting attention, and playing are the usual ways of dealing with death."

C. "School-aged children are inquisitive and ask a lot of questions about death."

An 8-year-old child has experienced the death of a sister. The child begins to ask many questions about what happens to the body after death. The parent wonders if this is abnormal behavior picked up from playing video games. Which is the best response by the nurse? A. "Playing video games can cause morbid behaviors." B. "Children handle the event of death more realistically than adults do." C. "School-aged children are inquisitive and ask a lot of questions about death." D. "Giggling, attracting attention, and playing are the usual ways of dealing with death."

C. "School-aged children are inquisitive and ask a lot of questions about death."

Which statement will the nurse need to consider when developing the teaching plan for a client with type 2 diabetes prescribed an oral hypoglycemic medication? A. Oral hypoglycemics work by decreasing absorption of carbohydrates. B. Oral hypoglycemics work by stimulating the pancreas to produce insulin. C. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control. D. Serious adverse effects are not a problem for oral hypoglycemics.

C. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.

Which information about the teenager's developmental stage would be considered before starting a counseling program for a 15-year-old with type 1 diabetes who has a history of noncompliance with the therapy regimen? A. They usually deny their illness B. They have a need for attention C. The struggle for identity is typical D. Regression is associated with illness

C. The struggle for identity is typical

Which strategy would the nurse teach the parents of a child who is being discharged from the hospital after a diagnosis of acute spasmodic laryngitis to help prevent another croup episode? A. Perform postural drainage. B. Discourage before-bedtime snacks. C. Use a cool mist vaporizer in the child's room. D. Demonstrate to the child how to expel air after inspiration.

C. Use a cool mist vaporizer in the child's room.

Which action would the nurse teach to a client with pulmonary tuberculosis who is prescribed a combination of rifampin and isoniazid? A. "Report any changes in vision." B. "Take the medicine with my meals." C. "Call my doctor immediately if my urine or tears turn red-orange." D. "Continue taking the medicine even after I feel better."

D. "Continue taking the medicine even after I feel better."

The parents of a child with recently diagnosed leukemia ask the nurse why their child has too many white blood cells. Which response by the nurse is BEST? A. "The health care provider is the best one to answer that question for you." B. "You seem to be focusing on your child's white blood cells." C. "You don't seem to understand what occurs in this disease." D. "The bone marrow is not controlling your child's white blood cell production as it should."

D. "The bone marrow is not controlling your child's white blood cell production as it should."

Which response would the nurse use when a client diagnosed with acquired immunodeficiency syndrome (AIDS) states, "I'm not worried because they have a cure for AIDS"? A. "Repeated phlebotomies may be able to rid you of the virus." B. "You may be cured of AIDS after prolonged pharmacological therapy." C. "Perhaps you should have worn condoms to prevent contracting the virus." D. "There is no cure for AIDS, but there are medications that can slow down the virus."

D. "There is no cure for AIDS, but there are medications that can slow down the virus."

Which blood pressure is optimal for an adolescent? A. 85/54 mm Hg B. 95/65 mm Hg C. 105/65 mm Hg D. 110/65 mm Hg

D. 110/65 mm Hg

A child has a fractured arm and multiple old injuries. Child maltreatment is suspected. Which parental characteristic supports this suspicion? A. Inquiring about the time of discharge B. Displaying signs of guilt about the injuries C. Expressing concern about the child's health D. Offering inconsistent stories about the injuries

D. Offering inconsistent stories about the injuries

Which activity places a client at risk for hyperthermia? A. Snowmobiling B. Skiing in the winter C. Hiking Alaskan mountains D. Performing strenuous activity in high humidity

D. Performing strenuous activity in high humidity

Which complication may develop in the child with hypospadias with chordee? A. Renal failure B. Testicular cancer C. Testicular torsion D. Sexual difficulties

D. Sexual difficulties

The nurse instructs the parents of an adolescent with asthma on how to reduce the allergens in the child's bedroom. The mother tells the nurse what she plans to do to make the room hypoallergenic. Which idea indicated that further teaching is needed? A. Removing a stuffed animal collection B. Storing off-season clothing in another room C. Covering the mattress with a plastic slipcover D. Using flat outdoor carpeting to cover hardwood floors

D. Using flat outdoor carpeting to cover hardwood floors

The nurse instructs the parents of an adolescent with asthma on how to reduce the allergens in the child's bedroom. The mother tells the nurse what she plans to do to make the room hypoallergenic. Which idea indicates that further teaching is needed? A. Removing a stuffed animal collection B. Storing off-season clothing in another room C. Covering the mattress with a plastic slipcover D. Using flat outdoor carpeting to cover hardwood floors

D. Using flat outdoor carpeting to cover hardwood floors