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发布时间:2024-02-01 20:48:53

[单项选择]When caring for a client with ulcerative colitis, the nurse should include which of the following nursing interventions in the plan of care()
A. Encouraging the use of stool softeners.
B. Suggesting sitz baths as needed.
C. Arrange for the client to have a private bathroom.
D. Wearing a gown to provide direct care.

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[单项选择]A client with ulcerative colitis is chatting with the nurse. Which of the following statements indicates the client understands the lifestyle modifications he needs to make()
A. "I will have to stop smoking. "
B. "I can eat popcorn for an evening snack. "
C. "I may have coffee with my meals. "
D. "I am allowed to have alcohol as long as I only drink wine. /
[单项选择]A client with a long history of ulcerative colitis takes sulfasalazine (Azulfidine) to control the condition. The nurse would anticipate the client to have which nutritional deficit that can occur as a result of taking this drug()
A. Colbalamin.
B. Folic acid.
C. Niacin.
D. Iron.
[单项选择]When caring for a client with preeclampsia, which action is a priority()
A. Monitoring the client’s labor carefully and preparing for a fast delivery.
B. Continually assessing the fetal tracing for signs of fetal distress.
C. Checking vital signs every 15 minutes to watch for increasing blood pressure.
D. Reducing visual and auditory stimulation.
[单项选择]When caring for a client with the nursing diagnosis Impaired swallowing related to neuromuscular impairment, the nurse should
A. position the client in a supine position.
B. elevate the head of the bed 90 degrees during meals.
C. encourage the client to remove dentures.
D. encourage thin liquids for dietary intake.
[单项选择]When caring for a client who has recently delivered, the nurse assesses the client for urinary retention with overflow. Which of the following provides the most accurate picture of retention with overflow()
A. Frequent trips to the bathroom with an average output of 200 to 300 mL per void.
B. Intense urge to urinate with an average output of 250 mL.
C. A varying urge to urinate with an average output of 100 mL.
D. Uterus displaced to the right with increased vaginal bleeding.
[单项选择]When caring for a client during the second stage of labor, which action would be least appropriate()
A. Assisting the client with pushing.
B. Ensuring the client’s legs are positioned appropriately.
C. Allowing the client clear liquids.
D. Monitoring the fetal heart rate.
[单项选择]When caring for a client with a major depression, the nurse usually has the most difficulty, dealing with the:( )
A. Client’s lack of energy
B. Negative nonverbal responses
C. Client’s psychomotor retardation
D. Pervasive quality of the depression
[单项选择]When caring for a client who has had a cesarean birth, which of the following nursing interventions is least appropriate( )
A. Removing the initial dressing for incision inspection.
B. Monitoring pain status and providing necessary relief.
C. Supporting self-esteem concerns about delivery.
D. Assisting with parental neonate bonding.
[单项选择]When caring for an adolescent client diagnosed with depression, the nurse should remember that depression manifests differently in adolescents and adults. In an adolescent, signs and symptoms of depression are likely to include which of the following( )
A. Helplessness, hopelessness, hypersomnolence, and anorexia.
B. Truancy, a change of friends, social withdrawal, and oppositional behavior.
C. Curfew breaking, stealing from family members, truancy, and oppositional behavior.
D. Hypersomnolence, obsession with body image, and valuing of peers’ opinions.
[单项选择]When caring for a client who is having her second baby, the nurse can anticipate the client’s labor will be which of the following()
A. Shorter than her first labor.
B. About half as long as her first labor.
C. About the same length of time as her first labor.
D. A length of time that can’t be determined based on her first labor.
[单项选择]When caring for a client with a 3-cm stage 1 pressure ulcer on the coccyx, which of the following actions can the nurse institute independently()
A. Using a povidone-iodine wash on the ulceration three times per day.
B. Using a normal saline solution and applying a protective dressing as necessary.
C. Applying an antibiotic cream to the area three times per day.
D. Massaging the area with an astringent every 2 hours.
[单项选择]The nurse is caring a client in an acute care mental health program. The client refuses his morning dose of an oral antipsychotic medication and believes he’s being poisoned. What should the nurse do( )
A. Crushing the medication and putting it in his food.
B. Consulting with the physician about a plan of care.
C. Administering the medication by injection.
D. Omitting the dose and trying again the next day.
[单项选择]The nurse is caring for a client with otosclerosis scheduled to undergo a stapedectomy. The client asks the nurse when her hearing will improve. Which response by the nurse is most appropriate()
A. Your hearing may not improve but you’ll no longer be bothered by tinnitus.
B. Your hearing may be dramatically improved right after surgery.
C. You may notice improved hearing within 1 to 2 weeks.
D. Your hearing may improve 3 to 6 weeks after surgery.
[单项选择]The nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice()
A. Straw-colored urine.
B. Reduced hematocrit.
C. Clay-colored stools.
D. Elevated urobilinogen in the urine.
[单项选择]The nurse is caring for a client with diabetes mellitus. When teaching the client about foot care, which instruction should the nurse provide()
A. Examine feet once per week for redness, blisters, and abrasions.
B. Apply lotion to dry feet, especially between the toes.
C. Avoid hot-water bottles and heating pads.
D. Dry feet vigorously after each bath.
[单项选择]The nurse is caring for a client during the fourth stage of labor. Which of the following nursing interventions would be LEAST appropriate()
A. Catheterization to protect the bladder from trauma.
B. Perineal assessments for swelling and bleeding.
C. Vital signs and fundal checks every 15 minutes.
D. Time with the neonate to initiate breast-feeding.

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