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NEW QUESTION 47
A 6-year-old child returned to the surgical floor 20 hours ago after an appendectomy for a gangrenous appendix. His mother tells the nurse that he is becoming more restless and is anxious. Assessment findings indicate that the child has atelectasis. Appropriate nursing actions would include:
- A. Having the child turn, cough, and deep breathe every 1-2 hours
- B. Remaining with the child and keeping as calm and quiet as possible
- C. Allowing the child to remain in the position of comfort, preferably semi-or high-Fowler position
- D. Administering analgesics as ordered
Answer: A
Explanation:
Section: Questions Set G
Explanation:
(A) Allowing the client to remain in the position of comfort will not resolve the atelectasis. This position, if left unchanged, over time may actually increase the atelectasis. (B) Analgesics will not resolve the atelectasis and may contribute to it if proper nursing actions are not taken to help resolve the atelectasis. (C) Having the client turn, cough, and deep breathe every 1-2 hours will aid in resolving the atelectasis. Surgery clients are at risk for postoperative respiratory complications because pulmonary function is reduced as a result of anesthesia and surgery. (D) Remaining with the client and keeping him calm and quiet will not affect the client's anxiety, restlessness, or help to resolve the atelectasis. The cause (atelectasis) needs to be treated, not the symptoms (anxiety and restlessness).
NEW QUESTION 48
A 50-year-old depressed client has recently lost his job. He has been reluctant to leave his hospital room.
Nursing care would include:
- A. Monitoring elimination patterns
- B. Providing sensory stimulation
- C. Encouraging the client to discuss why he is so sad
- D. Forcing the client to attend all unit activities
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) The client should be encouraged to attend the unit activities. The nurse and client should choose a few activities for the client to attend that will be positive experiences for him. (B) The nurse should encourage the client to discuss his feelings and to begin to deal with the depression. (C) Depressed persons often have little appetite and poor fluid intake. Constipation is common. (D) A calm, consistent level of stimuli is most effective. Sensory deprivation and overstimulation should be avoided.
NEW QUESTION 49
A 24-year-old graduate student recognizes that he has a phobia. He suffers severe anxiety when he is in darkness. It has altered his lifestyle because he is unable to go to a movie theater, concert, and other events that may require absence of light. The client is seeking assistance because he is no longer able to socialize with friends due to his phobia. The psychologist working with him is using desensitization. He has asked the nursing staff to assist the client in muscle relaxation techniques. What result would indicate client education has been successful?
- A. He states that he no longer fears dark places.
- B. He takes a part-time job as a photographic assistant. His job necessitates his working in a darkroom.
- C. He enters a concert, but as the lights dim, he does not experience anxiety.
- D. He enters a movie theater, sits in his chair, and replaces anxiety with relaxation as the theater darkens.
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) This situation provides specific evidence that the client is able to integrate muscle relaxation technique into his lifestyle to alleviate anxiety. (B) The client may not experience anxiety at the concert, but there is no evidence regarding the technique that he used to alleviate anxiety. (C) The client may state he no longer experiences anxiety, but there is no evidence demonstrating this. He may be denying anxiety to discontinue therapy prematurely. (D) Does he experience anxiety in the darkroom? He may have taken this job to force himself to deal with the phobia directly.
NEW QUESTION 50
A client had a right below-the-knee amputation 4 days ago. He is complaining of pain in his right lower leg.
The nurse should:
- A. Remind the client that he no longer has that part of his leg and assure him he will be OK
- B. Call the physician to request a psychological consultation for the client
- C. Give the client his order of Demerol 50 mg IM prn
- D. Turn on the television to distract the client's attention from his amputated leg
Answer: C
Explanation:
Explanation
(A) The nurse is ignoring the client's pain. Telling the client that he will be OK will not relieve his phantom pain. (B) The client does not need a psychological consultation. Phantom pain is a normal sensation experienced by clients with amputations. (C) Using the television as a distractor will not relieve the client's phantom pain. (D) Phantom pain is a normal, very real experience for an amputee and should be treated with pain medication.
NEW QUESTION 51
Two weeks after a client's admission for depression, the physician orders a consult for electroconvulsive therapy (ECT). Which of the following conditions, if present, would be a contraindication for ECT?
- A. Brain tumor or other space-occupying lesion
- B. Surgically repaired herniated lumbar disk
- C. History of mitral valve prolapse
- D. History of frequent urinary tract infections
Answer: A
Explanation:
Explanation
(A) A contraindication for ECT is a space-occupying lesion such as a brain tumor. During ECT, intracranial pressure increases. Therefore, ECT would not be prescribed for a client whose intracranial pressure is already elevated. (B) Any cardiac dysrhythmias or complications that arise during ECT are usually attributed to the IV anesthetics used, not to preexisting cardiac structural conditions. (C) Musculoskeletal injuries during ECT are extremely rare because of the IV use of centrally acting muscle relaxers. (D) A history of any kind of infection would not contraindicate the use of ECT. In fact, concurrent treatment of infections with ECT is not uncommon.
NEW QUESTION 52
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