EAQ #2 Nurs 220
A client who is pregnant for the first time attends the prenatal clinic. She tells the nurse, "I'm worried about gaining too much weight, because I've heard that it's unhealthy." How should the nurse respond?
"A 25-lb (11.3-kg) weight gain is recommended; however, the pattern of weight gain is more important than the total amount."
The nurse has provided instructions about back safety to a client. Which client statement indicates understanding of the instructions?
"I should carry objects close to my body."
The nurse determines that a young female client who is being treated for a sexually transmitted infection (STI) understands instructions regarding future sexual contacts. Which client statement confirms the nurse's conclusion?
"I won't have unprotected sex again, and I'll tell my partners to be tested for STIs."
A postpartum client tells the nurse that she wishes to breast-feed. When the nurse brings her newborn to be breast-fed, the client asks whether she may drink a small glass of wine to help her relax. How should the nurse respond?
"You seem a little tense. Tell me how you feel about breast-feeding."
A client who is scheduled for a muscle biopsy tells the nurse, "They better give me a general anesthetic. I don't want to feel anything." Which is the most therapeutic initial response by the nurse?
"You seem to be worried about the test."
What should the nurse explain to the parents of a newborn with developmental dysplasia of the hip (DDH) will most likely will be part of the infant's treatment?
A fitted Pavlik harness
A nurse is teaching a client about human immunodeficiency virus (HIV). What are the various ways HIV is transmitted? Select all that apply.
2. Sharing syringe needles 3. Breastfeeding a newborn 5. Anal intercourse -Fluids such as blood and semen are highly concentrated with HIV. HIV may be transmitted parenterally by sharing needles and postnatally through breast milk. HIV may also be transmitted through anal intercourse. HIV is not transmitted by mosquito bites or dry kissing.
Which psychosocial nursing actions are appropriate when providing client care after a community disaster? Select all that apply.
3. Offering choices whenever possible 4. Establishing rapport through active listening 5. Requesting assistance from crisis counselors
A client who only speaks Spanish is being cared for at a hospital in which nursing personnel only speak English. What communication technique would be appropriate for the nurse to use when discussing healthcare decisions with the client?
Contact an interpreter provided by the hospital.
A terminally ill client is moving gradually toward resolution of feelings about impending death. In a plan of care based on Elisabeth Kübler-Ross' research, the nurse should use nonverbal interventions after having assessed that the client is in which stage?
Acceptance stage
An 11-year-old child with juvenile idiopathic arthritis will be receiving continued nonsteroidal antiinflammatory drug (NSAID) therapy at home. Which important toxic effect of NSAIDs must be included in the nurse's discharge instructions to the child and family?
Blood in the urine
The nurse is assessing four clients who were injured in a mass casualty event. Which client does the nurse plan to treat first according to the disaster triage tag system?
Client belonging to class I
A nurse performs full range-of-motion exercises on a client's extremities. When putting an ankle through range-of-motion exercises, what must the nurse perform?
Dorsiflexion, plantar flexion, eversion, and inversion
A client at 32 weeks' gestation is admitted in active labor. Her cervix is effaced and dilated 4 cm. Intramuscular betamethasone 12 mg is prescribed. What should the nurse tell the client about why the medication is being given?
Fetal lung maturity is accelerated
The nurse should first discuss terminating the nurse-client relationship with a client during which phase?
Orientation phase, when a contract is established
Which synovial joint movement is involved in turning the client's palm downward?
Pronation
Morphine via an epidural catheter is prescribed for a client after abdominal surgery. The client asks the nurse why this medicine is necessary. What primary rationale does the nurse give for the administration of an opioid analgesic after abdominal surgery?
Relieves abdominal pain
A recently hospitalized client with multiple sclerosis is concerned about generalized weakness and fluctuating physical status. What is the priority nursing intervention for this client?
Space activities throughout the day.
Which statement is true about the skeletal system of toddlers?
The bones of toddlers can better withstand falls than those of older adults.
A disturbed client who has been out of touch with reality has been hospitalized for several weeks. One day the nurse notes that the client's hair is dirty and asks whether the client wants to wash it. The client answers, "Yes, and I'd like to shower and change my clothes, too." What can the nurse conclude about the client in relation to this response?
The client has some feelings of self-worth.
