While working on a postoperative unit, the nurse is applying the elements of the self-care theory. The nurse who assists the client to manage or attain self-care in wound management is using the theory developed by: 1. Imogene King 2. Dorothea Orem 3. Virginia Henderson 4. Florence Nightingale ANSWER ANS: 2 The goal of […]
The nurse is explaining the rationale for seeking the family’s permission to apply a physical re-straint to a combative client. This is an example of the nurse exhibiting the professional principle of: 1. Advocacy 2. Responsibility 3. Accountability 4. Confidentiality ANSWER ANS: 3 Accountability refers to the ability to answer for one’s own actions. […]
Besides being pivotal in the growth, maintenance, and repair of body tissue, protein plays a sig-nificant role in the body’s ability to: (Select all that apply.) 1. Produce T cells 2. Manage bleeding 3. Produce carbon dioxide 4. Maintain blood pressure 5. Manage waste production 6. Transport drugs systemically ANSWER ANS: 1, 2, 4, […]
The nurse realizes that an individual client’s value system is most affected by: 1. Life experiences 2. Economic status 3. Spiritual beliefs 4. Formal education ANSWER ANS: 1 Development of values begins in childhood, shaped by experiences within the family unit, espe-cially dramatic events during the formative years. The other options may influence the […]
The nurse is identifying outcomes for a client with the nursing diagnosis Stress Urinary Incontinence. Which outcome would be related to sphincter incompetence? 1. The client will empty her bladder every time she voids. 2. The client will improve her incontinence within 1 month. 3. The client will perform four to five squeezes for 5 […]
Nitrogen balance testing is planned for a client. What instruction to the staff caring for this client is essential? 1. Remove the client’s oxygen cannula 10 minutes prior to the test. 2. Accurate measurement of food intake is very important. 3. All urine output should be collected for 48 hours. 4. Keep the client NPO […]
A client experienced female circumcision as a puberty ritual while living in Africa as a child. For which health problem should the nurse monitor the client as an adult? 1. Early menopause 2. Increased menstrual flow 3. Chronic urinary tract infection 4. Tendency for postpartum hemorrhage ANSWER Correct Answer: 3 Rationale 1: There is […]
The client who is bed-bound complains of abdominal pain. Bowel sounds are present. What action should be taken by the nurse? 1. Percuss for flatness over the liver. 2. Palpate for bladder fullness. 3. Use the p.r.n. order to medicate the client with an antacid. 4. Inspect the sacral area for edema. ANSWER Correct […]
The nurse is determining whether interventions to address the diagnosis of Spiritual Distress for a client newly diagnosed with a chronic illness have been effective. What outcome would indicate that interventions have been effective for this client? 1. The client has talked with the church priest twice during the hospitalization. 2. The client states that […]
During the admission history, the client informs the nurse that she follows a macrobiotic diet. The nurse knows that the client’s diet includes: 1. Increased meats and other proteins 2. A 30%/40%/30% protein/carbohydrate/fat ratio 3. Increased intake of vitamin C and beta-carotene 4. Whole grains, vegetables, and fish ANSWER ANS: 4 A macrobiotic diet […]
