Nursing - Communications & Family Dynamics

One day a nurse sits down by a depressed client's bed and says, "I'll be spending some time with you today." The client responds, "Go talk to someone else. They all need you more." What is the most therapeutic response by the nurse?

"I'll be spending the next half hour with you."

A pregnant woman tells a nurse in the prenatal clinic that she knows that folic acid is very important during pregnancy and that she is taking a prescribed supplement. She asks the nurse what foods contain folic acid (folate) so she may add them to her diet in its natural form. Which foods should the nurse recommend? Select all that apply.

Black and pinto beans Enriched bread and pasta

The nurse is caring for a couple who just received amniocentesis results indicating that their fetus has trisomy 18. Why is it important for a nurse to support the parents' decision to abort a fetus with a birth defect even if the nurse is morally opposed to abortion?

It is important for maintenance of the family equilibrium

What fact about eczema should a nurse discuss with the parents of a child in whom the condition has just been diagnosed?

It is mainly found in infants

What should the nurse do when an adolescent girl with the diagnosis of anorexia nervosa starts to discuss food and eating?

Tell the client gently but firmly to direct her discussion of food to the nutritionist.

The health care provider prescribes finasteride (Proscar) for a client with benign prostatic hyperplasia. The nurse informs the client that:

protection should be worn during intercourse with a pregnant female

A paranoid client is scheduled to begin group therapy. The client refuses to attend. What should the nurse do next?

Accept the client's decision without discussion

A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client's clinical record? Select all that apply

Acetone breath Decreased arterial carbon dioxide level

The parents of a toddler with recently diagnosed moderate cognitive impairment state, "My child should be able to attend college with help and medication." What should the nurse conclude?

Denial is being used as a defense.

A nurse is caring for a client with a tentative diagnosis of pheochromocytoma who is receiving chlorpromazine (Thorazine). A 24-hour urine specimen to assess the presence of vanillylmandelic acid (VMA) is prescribed to assist in the confirmation of the diagnosis. What information should the nurse include in the client teaching regarding this test? Select all that apply

All urine excreted over the 24-hour period must be saved and refrigerated. Avoid coffee, chocolate, and citrus fruit for three days before and during the test

A client is diagnosed with cancer of the larynx and is scheduled for a total laryngectomy. What should the nurse include in the preoperative teaching plan?

Allowing the client an opportunity to ask questions

A client with Hodgkin disease is to receive the cyclic antineoplastic vincristine (Oncovin) as part of a therapy protocol. The client asks how this medication works. The nurse explains in language that the client will understand that vincristine helps destroy the malignant cells by:

Arresting mitosis in metaphase

A nurse is caring for a client with the diagnosis of alcohol withdrawal delirium. Which action is most appropriate for the nurse to implement?

Assuring the client that the symptoms are part of the withdrawal syndrome

A nurse develops a relationship with a client who has bipolar disorder with episodes of mania. The nurse concludes that their therapeutic interaction has entered the working stage when the client:

Explores the effect of bipolar behavior on the family

A pregnant client is making her first antepartum visit. She has a 2-year-old son born at 40 weeks, a 5-year-old daughter born at 38 weeks, and 7-year-old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. How does the nurse, using the GTPAL format, document the client's obstetric history?

G5 T2 P1 A1 L4

After treatment an adolescent with a history of schizophrenia improves and is to be discharged. The parents tell the nurse that they are concerned about how to respond "if he starts to act crazy." What is the most therapeutic response by the nurse?

Having the parents discuss mutual concerns with their child before the discharge date

A nurse approaches a depressed client who is sitting alone in the dayroom. What is best for the nurse to say to the client?

I'll be sitting with you for a while today.

A client admitted for substance abuse detoxification is displaying severe anger toward his spouse. In light of this information, the nurse manager determines that the situation was handled:

Inappropriately, because the nurse failed to effectively address the client's threat of physical harm to his wife

A nurse on the psychiatric unit is conducting group therapy with clients who have diagnoses of polydrug abuse. This is a closed group. Four sessions have been held, and the group is now in the working phase. Which strategy is most beneficial for the nurse facilitator to use during the next session?

Providing a balance between support and skillful therapeutic confrontation

A nurse is preparing a preschooler for an elective surgical procedure. How much time should the nurse allow between telling the child about the surgery and the actual surgery?

Several days

A nurse is teaching the parents of a 5-year-old girl who is to continue chemotherapy at home. What statement indicates that the parents understand the discharge instructions?

We'll let her eat at her own pace.

A client with intermittent claudication has been instructed to stop smoking. The nurse explains that the reason that the client should quit smoking is because:

Nicotine is a vasoconstrictor and should be avoided in clients like you with arterial problems.

A nurse is assessing a toddler and the family dynamics of the child's family, in which abuse is suspected. What behaviors are expected? Select all that apply.

The child cringes when approached. The child has unexplained healed injuries. The child lies still while surveying the environment

A client confides to the nurse, "I've been thinking about suicide lately." What conclusion should the nurse make about the client?

The client is fearful of the impulses and is seeking protection from them.

The parents of a 7-year-old child who has undergone open-heart surgery are informed that their child is in the postanesthesia care unit and is stable. The parents are crying and openly express their worries and fears. What is the best response by the nurse?

Bringing them to the recovery area for several minutes

During a routine physical examination a 10-year-old girl is discovered to have scoliosis. The curve is diagnosed as mild and functional, and a daily exercise program is established. The next month, at the follow-up visit, the nurse determines that the child is complying with the exercise program when the girl states:

"I think my exercises will make me a better softball and soccer player."

A client is admitted to the psychiatric unit during the first episode of an acute psychotic disorder. The plan of care calls for psychiatric, medical, and neurological evaluation. What essential intervention should be included in the plan?

Instituting psychopharmacologic prescriptions and supportive communication

A client has a modified radical mastectomy because of a malignant tumor of the breast. What does the nurse plan to teach the client during the early postoperative period?

Keep the arm in an elevated position

A client on bed rest develops bronchitis and atelectasis of the right lower lobe. The nurse provides teaching about the treatment plan and explains that the recommended client position is:

Lying on the left side to promote drainage

A client is admitted for a coronary artery bypass graft. The client states that the preoperative teaching materials contain information about pacemaker wires being inserted during surgery as a precautionary measure. The client asks, "What is the purpose of the pacemaker?" The best response by the nurse is, "The pacemaker:

Manages an abnormally slow heart rate.