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NEW QUESTION 24
In admitting a client to the psychiatric unit, the nurse must explain the rules and regulations of the unit. A client with antisocial personality disorder makes the following remark, “Forget all those rules. I always get along well with the nurses.” Which nursing response to him would be most effective?
- A. “OK, don’t listen to the rules. See where you end up.”
- B. “I’m pleased that you get along so well with the staff.You must still know and abide by the rules.”
- C. “It is irrelevant whether you get along with the nurses.”
- D. “I’m not the other nurses. You better read the rules yourself.”
Answer: B
Explanation:
Explanation
(A) This answer is incorrect. A nurse should be an appropriate role model. Threats are not appropriate. No limit setting was stated. (B) This answer is correct. The nurse made a positive statement followed by a simple, clear, concise setting of limits. (C) This answer is incorrect. It appears to have a negative connotation. There was no limit setting. (D) This answer is incorrect. The nurse obviously responded in a negative manner.
Learning takes place more readily when one is accepted, not rejected. No limits were set.
NEW QUESTION 25
In evaluating the effectiveness of magnesium sulfate (MgSO4), which of the following might indicate that the client was developing MgSO4 toxicity?
- A. Respirations of 12 breaths/min
- B. Urine output of 40 mL/hr
- C. A 21 proteinuria value
- D. A 31 patellar tendon reflex
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Diminished (not accentuated) patellar tendon reflex is a sign of developing MgSO4 toxicity. A value of
21 is considered a normal tendon reflex; 3+ is considered brisker than normal. (B) MgSO4 is a central nervous system (CNS) depressant. It also relaxes smooth muscle. If the respiratory rate is <16 bpm magnesium toxicity may be developing. (C) Urine output of 40mL/hr is enough to allow elimination of toxic levels of magnesium. Urinary output of <100 mL in a 4-hour period may result in toxic levels of magnesium.
(D) Presence of protein in the urine is a symptom of pregnancy-induced hypertension (PIH), a clinical syndrome for which magnesium sulfate is frequently used in medical management. Protein in the urine is not induced by magnesium sulfate intake.
NEW QUESTION 26
Early in her ninth month of pregnancy, a client has been diagnosed as having mild preeclampsia. In counseling her about her diet, the nurse must emphasize the importance of:
- A. Increasing her carbohydrate intake
- B. Decreasing her sodium intake
- C. Eating a moderate to high-protein diet
- D. Decreasing her fluids
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Women with pregnancy-induced hypertension have a reduced plasma volume secondary to venous vessel constriction, not hypovolemia; therefore, sodium restriction is not recommended. It is suggested that these women avoid extremely salty foods. (B) Drinking six to eight glasses of water per day facilitates optimal fluid volume and renal perfusion, but it will not decrease the venous vessel constriction of pregnancy-induced hypertension. (C) Carbohydrate needs increase during pregnancy, specifically during the second and third trimesters, but they have not been linked to pregnancy-induced hypertension. (D) Loss of urinary protein (proteinuria) is associated with increased permeability of the large protein molecules with pregnancy-induced hypertension.Additional dietary protein also helps increase the plasma colloidal osmotic pressure. Diets deficient in protein have been linked to pregnancy-induced hypertension.
NEW QUESTION 27
A client is taught to eat foods high in potassium. Which food choices would indicate that this teaching has been successful?
- A. Pork chop, baked acorn squash, brussel sprouts
- B. Tuna casserole, noodles, and spinach
- C. Roast beef, baked potato, and diced carrots
- D. Chicken breast, rice, and green beans
Answer: A
Explanation:
(A) Both acorn squash and brussels sprouts are potassium-rich foods. (B) None of these foods is considered potassium rich. (C) Only the baked potato is a potassium-rich food. (D) Spinach is the only potassium-rich food in this option.
NEW QUESTION 28
An 11-year-old boy has received a partial-thickness burn to both legs. He presents to the emergency room approximately 15 minutes after the accident in excruciating pain with charred clothing to both legs. What is the first nursing action?
- A. Apply Silvadene cream (silver sulfadiazine).
- B. Begin debridement by removing all charred clothing from wound.
- C. Apply ice packs to both legs.
- D. Immerse both legs in cool water.
Answer: D
Explanation:
Explanation
(A) Ice creates a dramatic temperature change in the tissue, which can cause further thermal injury. (B) Charred clothing should not be removed from wound first. This creates further tissue damage. Debridement is not the first nursing action. (C) Applying silver sulfadiazine cream first insulates heat in injured tissue and increases potential for infection. (D) Emergency care of a thermal burn is immersing both legs in cool water.
Cool water permits gradual temperature change and prevents further thermal damage.
NEW QUESTION 29
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