EAQ4

A teenager begins to cry while talking with the nurse about the problem of not being able to make friends. Which is the correct therapeutic nursing intervention? 1 Sitting quietly with the client 2 Telling the client that crying is not helpful 3 Suggesting that the client play a board game 4 Recommending how the client can change this situation

Sitting quietly with the client

Which factor would the nurse assess in a client reporting constipation? Select all that apply. One, some, or all responses may be correct. 1 Diet 2 Fluid intake 3 Use of laxatives 4 Date of last bowel movement 5 Use of opioid pain medications

all of the above

Which instruction would the nurse provide to a 6' 0", 160-pound client newly diagnosed with type 1 diabetes who wants to self-administer injections with an insulin pen? Select all that apply. One, some, or all responses may be correct. 1 Prime the needle with two units. 2 Use a 29-gauge insulin needle. 3 Give the injection at 45-degree angle. 4 Refrain from recapping the needle. 5 Dial the pen to deliver the unit dose.

all of the above.

How much water should a patient with a stony drink?

drink at least 3000 mL of fluid in a 24-hour period and even more when the weather is hot.

when should an ostomy pouch be emptied?

when its one third full?

A client with an upper respiratory infection asks the nurse why the health care provider did not prescribe an antibiotic. Which response from the nurse would be the best? 1 "I don't know; however, I will ask your health care provider for a prescription as soon as possible." 2 "Antibiotics are used to treat viruses, and your cultures indicate the presence of a bacterial infection." 3 "Antibiotics are ineffective for treating the bacteria that caused your upper respiratory infections." 4 "Upper respiratory infections are generally caused by viruses and would not be treated with antibiotics."

"Upper respiratory infections are generally caused by viruses and would not be treated with antibiotics."

Which nursing intervention would be included in the plan of care for a client who has a disturbed body image as a result of a burn injury? 1 Conveying a positive attitude toward the client 2 Arranging for the client's family to meet other families of clients with burns 3 Removing mirrors until the client's physical appearance has improved 4 Reminding family members to avoid comments about the client's appearance

1.

The nurse is assessing a client who reports shortness of breath. Which activity best ensures that the nurse obtains accurate and complete data to prevent a nursing diagnostic error? 1 Assess the client's lungs. 2 Assess the client for pain. 3 Obtain details of smoking habits. 4 Ask about the onset of shortness of breath.

1.Assess the client's lungs.

Which information would the nurse provide to decrease the incidence of further infections in a 17-year-old female who has experienced multiple non-sexually transmitted genitourinary infections? Select all that apply. One, some, or all responses may be correct. 1.Dry off after swimming. 2.Select cotton underwear 3.Wear loose-fitting clothes. 4.Avoid taking bubble baths. 5.Refrain from scented toilet tissue.

1.Dry off after swimming. 2.Select cotton underwear 3.Wear loose-fitting clothes. 4.Avoid taking bubble baths. 5.Refrain from scented toilet tissue.

Which trigger would the nurse instruct a client to avoid to decrease the incidence of asthma attacks? Select all that apply. One, some, or all responses may be correct. 1.Mold 2.Cold air 3.Pet dander 4.Air pollution 5.Cigarette smoke

1.Mold 2.Cold air 3.Pet dander 4.Air pollution 5.Cigarette smoke

Which instruction would the nurse include when providing education about firearm safety to parents of elementary school children? Select all that apply. One, some, or all responses may be correct. 1.Purchase and use safety locks. 2.Emphasize that firearms are not toys. 3.Never point a firearm at anyone. 4.Keep firearms in a locked cabinet. 5.Store ammunition away from firearms

1.Purchase and use safety locks. 2.Emphasize that firearms are not toys. 3.Never point a firearm at anyone. 4.Keep firearms in a locked cabinet. 5.Store ammunition away from firearm

A child is ordered a broad-spectrum antibiotic to be administered three times a day. Which times would the nurse instruct the parents to administer the medication at home? 1.8:00 AM, 2:00 PM, 8:00 PM 2.6:00 AM, 2:00 PM, 10:00 PM 3.6:00 AM, 12:00 PM, 8:00 PM 4.10:00 AM, 4:00 PM, 10:00 PM

2.6:00 AM, 2:00 PM, 10:00 PM

The nurse is preparing to teach a client about self-injection of insulin. Which action by the nurse will increase the effectiveness of the teaching session? 1.Wait until a family member is also present. 2.Assess the client's barriers to learning self-injection techniques. 3.Begin with simple written instructions describing the technique. 4.Wait until the client has accepted the new diagnosis of type 1 diabetes mellitus.

2.Assess the client's barriers to learning self-injection techniques

An older client is apprehensive about being hospitalized for the first time. Which intervention is correct for the nurse to perform to limit the client's stress? 1 Use the client's first name. 2 Visit with the client frequently. 3 Explain what the client can expect. 4 Listen to what the client has to say.

3

Which recommendation would the nurse provide to a client with gastroesophageal reflux disease (GERD) who asks how to reduce heartburn and pain without taking medication? Select all that apply. One, some, or all responses may be correct. 1 Chew hard mint candies. 2 Eat a small bedtime snack. 3 Elevate the head of the bed 5 inches. 4 Avoid white wine consumption. 5 Consume three large meals per day.

3

Which instruction would the nurse provide to an older client using ice and heat to treat pain from back strain? Select all that apply. One, some, or all responses may be correct. 1 Switch positions every 4 hours. 2 Use a heating pad for the first 24 hour 3 Apply for 30-minute time intervals. 4 Place the ice pack directly to injury site. 5 Take ibuprofen every 4 hours PRN.

3.

Which action would the nurse take to prevent aspiration recurrence in a client with aspiration pneumonia who is NPO status with a nasogastric tube and a prescription for antibiotics? Select all that apply. One, some, or all responses may be correct. 1.Obtaining vital signs after feedings 2.Administering intravenous antibiotics 3.Elevating the head of the bed to 30 degrees 4.Determining residual every 4 hours 5.Assessing for the gag reflex before feeding

3.Elevating the head of the bed to 30 degrees

Which information to promote self-management would the nurse provide to a client being discharged with a new ileostomy? Select all that apply. One, some, or all responses may be correct. 1 Consume 1000 mL/day of fluid. 2 Limit alcohol to one or two glasses daily. 3 Include plenty of nuts and seeds in the diet. 4 Change the appliance every 4 to 7 days. 5 Empty the ostomy pouch when it is two-thirds full.

4

Which key factor would the nurse consider when assessing how a client will cope with body image changes? 1 Suddenness of the change 2 Obviousness of the change 3 Extent of the change 4 Perception of the change

4

A client engages in angry outbursts and places excessive demands on the staff. An unlicensed health care worker tells the nurse, "I've had it. I am not putting up with that behavior. I'm not going in there again." Which is the correct response by the nurse? 1 "You need to try to be patient. The client is going through a lot right now." 2 "I'll talk with the client. Maybe I can figure out the best way for us to handle this." 3 "Just ignore it and get on with your work. I'll assign someone else to take a turn." 4 "The client is frightened and taking it out on the staff. Let's think of approaches we can take."

4.

The nurse is caring for a client who has lost an arm in a motor vehicle accident. Which reaction cues the nurse to realize that the client is in the withdrawal phase of adjusting to the change in body image? 1.The client is going through a grieving period. 2.The client talks as if another person is affected. 3.the client is willing to learn techniques to adapt. 4.The client recognizes the reality and becomes anxious.

4.

Why shouldn't a client with an stony consume seeds or nuts?

Clients should avoid alcohol of any kind because it can cause diarrhea. Nuts and seeds can become trapped in the bowel

Which action would the nurse perform when administering fluticasone propionate to a client with asthma? Select all that apply. One, some, or all responses may be correct. 1 Assessing heart rate and rhythm 2 Monitoring liver function blood tests 3 Rinsing the oral cavity with water after use 4 Obtaining blood glucose levels before meals 5 Giving stool softeners to prevent constipation

Rinsing the oral cavity with water after use