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发布时间:2024-02-01 21:07:53

[单项选择]The nurse walks into the room of a client who has had surgery for testicular cancer. The client says that he’ll be undesirable to his wife, and he becomes tearful. He expresses that he’s spoiled a happy, satisfying sex life with his wife, and says that he thinks it might be best if he would just die. Based on these signs and symptoms, which nursing diagnosis would be most appropriate for planning purposes ?()
A. Situational low self-esteem.
B. Unilateral neglect.
C. Social isolation.
D. Risk for loneliness.

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[单项选择]The nurse walks into the room of a client who has had surgery for testicular cancer. The client says that he’ll be undesirable to his wife, and he becomes tearful. He expresses that he’s spoiled a happy, satisfying sex life with his wife, and says that he thinks it might be best if he would just die. Based on these signs and symptoms, which nursing diagnosis would be most appropriate for planning purposes
A. Situational low self-esteem.
B. Unilateral neglect.
C. Social isolation.
D. Risk for loneliness.
[单项选择]The nurse is teaching a client who has been prescribed allopurinol for the treatment of gout. Which instruction would the nurse give to the client
A. Increase alcohol intake while taking the drug.
B. Avoid foods that are rich in purine.
C. Take aspirin for pain.
D. Take the drug between meals to promote absorption.
[单项选择]The nurse is caring for a client who has generalized anxiety disorder. Which statement is true about this client
A. The client has regular obsessions.
B. Relaxation techniques and psychotherapy are necessary for cure.
C. Nightmares and flashbacks are common in individuals who suffer from generalized anxiety disorder.
D. Generalized anxiety disorder is characterized by anxiety that lasts longer than 6 months.
[单项选择]The nurse is caring for a client who has hemoconcentration after fluid loss. Which IV fluids would be the most appropriate fluid replacement therapy for this client
A. Distilled water.
B. Dextrose 5% in water (D5W) only.
C. DSW with 40 mEq of potassium chloride.
D. Dextrose 10% in salin
[单项选择]The nurse is caring for a client who has a history of alcohol abuse. Why would the client act as if he didn’t have a problem
A. The client has never taken the CAGE questionnaire.
B. Denial is a defense mechanism commonly used by alcoholics.
C. Thought processes are distorted.
D. Alcohol is expensiv
[单项选择]The nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She’s in her 30s and has two young children. Although she’s worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping
A. Tell the client’s spouse or partner to be supportive while she recovers.
B. Encourage the client to proceed with the next phase of treatment.
C. Recommend that the client remain cheerful for the sake of her children.
D. Refer the client to the American Cancer Society’s Reach for Recovery program or another support program.
[单项选择]The nurse is caring for a comatose client who has suffered a closed head injury. What intervention should the nurse implement to prevent increases in intracranial pressure (ICP)
A. Suction the airway every hour and as needed.
B. Elevate the head of the bed 15 to 30 degrees.
C. Turn the client and change his position every 2 hours.
D. Maintain a well-lit room.
[单项选择]The nurse is caring for a client who has had an above-the-knee amputation. The client refuses to look at the stump. When the nurse attempts to speak with the client about his surgery, he tells the nurse that he doesn’t wish to discuss it. The client also refuses to have his family visit. The nursing diagnosis that best describes the client’s problem is
A. hopelessness.
B. powerlessness.
C. disturbed body image.
D. fear.
[单项选择]The nurse has a client at 30 weeks’ gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when she says that she wants to breast-feed her neonate
A. Encourage breas-feeding so that she can get her rest and get healthier.
B. Encourage breast-feeding because it’s healthier for the neonate.
C. Encourage breast-feeding to facilitate bonding.
D. Discourage breast-feeding because HIV can be transmitted through breast milk.
[单项选择]The nurse is interviewing a client who is currently under the influence of a controlled substance and shows signs of becoming agitated. Which measure should the nurse take first when caring for this client
A. Be aware of hospital security.
B. Communicate a scolding attitude to intimidate the client.
C. Use confrontation.
D. Express disgust with the client’s behavior.
[单项选择]The nurse is teaching a client who receives nitrates for the relief of chest pain. Which of the following instructions should the nurse emphasize
A. Repeat the dose of sublingual nitroglycerin every 15 minutes for three doses.
B. Store the drug in a cool, well-lit place.
C. Lie down or sit in a chair for 5 to 10 minutes after taking the drug.
D. Restrict alcohol intake to two drinks per day.
[单项选择]The nurse is assessing a client who gave birth yesterday. Where should the nurse expect to find the top of the client’s fundus
A. One fingerbreadth above the umbilicus.
B. One fingerbreadth below the umbilicus.
C. At the level of the umbilicus.
D. Below the symphysis pubis.
[单项选择]The nurse observes that a depressed client has bathed, is wearing a clean blouse and slacks, and has combed her hair. Which statement by the nurse would be most helpful for the client
A. "I like your blouse and slacks. "
B. "You look good today. "
C. "I’m glad you’re feeling better today. "
D. "I’m glad you combed your hair today. "
[单项选择]The nurse has been teaching the client strategies to prevent a recurrence of hemorrhoids. One strategy is maintaining a high-fiber diet. Which of the following breakfast menus is appropriate for the client
A. Danish pastry, prune juice, coffee, and milk.
B. Oatmeal, milk, grapefruit wedges, and bran muffin.
C. Corn flakes, milk, white toast, and orange juice.
D. Scrambled eggs, bacon, English muffin, and apple juic
[单项选择]The nurse is teaching a client who is 28 weeks pregnant and has gestational diabetes how to control her blood glucose levels. Diet therapy alone has been unsuccessful in controlling her blood glucose levels, so she has started insulin therapy. The nurse should consider the teaching effective when the client says
A. "I won’t use insulin if I’m sick. "
B. "I need to use insulin each day. "
C. "If I give myself an insulin injection, I don’t need to watch what I eat. "
D. "I’ll monitor my blood glucose levels twice a week. "

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