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Medical Surgical Nursing Critical Thinking in Client Care Single Volume 4th Edition By Priscilla T LeMone -Test Bank
- MC A client asks the nurse, “What’s the difference between having good health and being well?” Which of the following could the nurse say in response?
- “Wellness is a passive state of freedom from illness.”
B.* “Wellness maximizes individual potential.”
- “Good health maximizes individual potential.”
- “There isn’t a difference.”
- MC A client tells the nurse, “Everyone in my family holds extra weight around their hips and legs.” The nurse realizes this client is describing which of the following health risk factors?
- Cultural background
- Developmental level
C.* Genetic makeup
- Cognitive ability
- MC An African-American client comes into the clinic for a routine check-up. The nurse realizes this client is most prone to developing which of the following health conditions?
- Diabetes mellitus
- MC The nurse is caring for a male client with heart disease. Which of the following would be considered the health promotion behavior with the greatest impact for this client?
- Perform breast self—examinations.
- Perform foot self-examinations daily.
C.* Cease smoking.
- Have a tetanus booster every ten years.
- MC The client asks the nurse for information about healthy living. Which of the following topics should the nurse review with this client? (Select all that apply.)
- Incorporate mild exercise into a daily routine.
B.* Cease smoking.
C.* Eat three balanced meals per day.
- Avoid red wine.
E.* Sleep seven to eight hours per day.
- MC A client is admitted with an alteration in pancreatic functioning. The nurse realizes this client is experiencing which of the following causes of disease?
- MC A client with an acute illness asks, “How long will I be sick? I need to get back to work.” The nurse realizes this client’s statement will:
- Cause the client to have a relapse.
- Have no impact on the recovery phase.
- Adversely affect the recovery phase.
D.* Most likely cause the client to adhere to the treatment plan.
- MC A client with a chronic illness says, “I must be getting better because I don’t have any of the symptoms I used to have.” The nurse realizes this client is demonstrating:
- MC The nurse is planning a primary prevention program for a group of clients. Which of the following topics could be included in this program?
- The need for annual tuberculosis tests
B.* Seat belt safety
- The goals of cardiac rehabilitation
- The purpose of diabetes mellitus detection screenings
- MC A 22-year-old client says, “I have no reason to keep going. I have no job, no home, and no family.” The nurse realizes this client is at risk for:
- Nothing. This is normal young adult behavior.
- Onset of disease.
- Unsafe sexual practices.
- MC A female client says, “I seem to be gaining weight ever since I turned 40.” Which statement by the nurse is most therapeutic?
A.* “The metabolic rate change that occurs with age and less physical activity could be the cause.”
- “There isn’t anything you can do about it.”
- “You aren’t as young as you used to be.”
- “You must be overeating.”
- MC A 47-year-old female client says, “I worry about my parents everyday and my job is overwhelming.” The nurse realizes this client is most at risk for:
- A divorce.
B.* Psychosocial stress.
- Committing suicide.
- Developing cancer.
- MC The middle-aged adult client says, “I want to spend more time volunteering at the local food bank.” The nurse identifies this statement as being:
- A potential weight management problem for the client.
- Of no significance.
- A desire to be around food.
D.* An achievement of a significant developmental task.
- MC A middle-aged adult is asking questions about avoiding the onset of heart disease. Which of the following would be an appropriate intervention for this client?
- Tell the client that heart disease is not a concern at their age.
- Sign them up to learn CPR.
C.* Suggest that the client attend a one-day seminar about ways to prevent or reduce heart disease.
- Ask the client the reasons for concern.
- MC A 79-year-old male comes into the clinic for prescription renewals. The nurse realizes this client would be categorized as being:
- MC A middle-old client says, “I wish I didn’t have high blood pressure and this arthritis is killing me.” The most therapeutic response by the nurse would be:
- “Be glad you don’t have cancer.”
- “I don’t expect to see your age myself.”
C.* “These illnesses are an unfortunate occurrence associated with aging.”
- “I would think you would be happy just to be alive.”
- MC An old-old client tells the nurse, “I hate all of those throw rugs my daughter has on the floor.” Which of the following is the most significant risk factor for this client?
- Urinary tract infection
- MC A middle-old client is not recovering as anticipated from an acute respiratory infection. Which statement by the nurse can provide the most useful assessment information?
- “Are you sleeping at least seven hours per night?”
- “Are you drinking enough fluids?”
C.* “Have you been able to purchase the antibiotics the doctor prescribed?”
- “Are you eating at least five servings of fruits and vegetables per day?”
- MC An elderly client says, “I can’t ask my daughter to do too much for me during the day because she has to go to work.” The nurse realizes this client is describing which of the following family features?
- Performing family tasks
- Adapting to change
D.* Maintaining boundaries
- MC A family unit that consists of two middle-aged adults has no children who live at home. Which of the following developmental tasks is important for this family to accomplish?
A.* Reestablish their relationship.
- Close the family home.
- Promote joint decision making with adults and children.
- Balance freedom with independence.
- MC The parent of two preschool children voices concerns to the nurse about feeling “stressed” lately and being worried about the limited amount of time to devote to the marriage. Based upon knowledge of the stages of family development, what are the primary tasks for the family during this time?
- Accept mortality of older friends and family members.
- Adjust to increased financial responsibilities.
- Reestablish the marital relationship after expansion of the family.
D.* Encourage the educational achievement of the children in the family.
- MC A client tells the nurse, “I seem to need one more drink each night after work, just to unwind.” The nurse realizes this client is describing:
- Withdrawal symptoms.
- Substance abuse.
- MC A nurse calls off from work periodically and has a known history of using alcohol. This nurse is most likely demonstrating:
C.* Substance abuse.
- Substance dependence.
- MC A client who was sexually abused as a child tells the nurse, “I just like to try different drugs recreationally.” The nurse realizes this client:
A.* Has low self-esteem and difficulty expressing emotions.
- Has an addictive personality.
- Wants to fit into his peer group.
- Has a mental illness.
- MC The nurse manager has been alerted to an unusually high number of “wasted” narcotics in the care area. Which of the following should the nurse do about this finding?
- Have an educational program provided to all staff about narcotic use.
- Nothing. This could be a normal occurrence.
C.* Realize that a substance abuse problem may be occurring with a staff member and begin closer observation.
- Review the records to see which clients were prescribed the wasted narcotics and interview them.
- MC A client has been diagnosed with alcoholism which is causing him to be depressed. The nurse realizes these diagnoses are indicative of:
- Sexual abuse as a child.
D.* A dual disorder.
- MC A pregnant client continues to smoke so that she “doesn’t gain a lot of weight.” Which of the following can the nurse instruct this client about smoking while pregnant?
- “It will not harm the infant.”
- “It will prevent some weight gain.”
C.* “It can cause low birth weight in the infant.”
- “It doesn’t prevent weight gain.”
- MC A 76-year-old male who used to run a bar and restaurant comes into the clinic with progressive numbness and tingling of all four extremities. For which of the following should this client be evaluated?
- Psychological dependence.
D.* Korsakoff’s psychosis.
- MC A 48-year-old male with a history of chronic marijuana use tells the nurse that his wife cannot get pregnant and wants to have fertility testing done. Which of the following would be an appropriate response for the nurse to make to this client?
A.* “Marijuana adversely affects the sperm and testosterone levels in men.”
- “Children would cost money and maybe he would have to reduce his marijuana use.”
- “It wouldn’t hurt to see which partner has the fertility issues.”
- “Having a baby at his age might not be a good idea.”
- MC A 35-year-old client with a history of barbiturate abuse tells the nurse that she “likes to have a few drinks with friends”. The nurse realizes this client is at risk for:
- Dual disorders.
- Withdrawal symptoms.
- Psychotic illness.
- MC A client with a crystal methamphetamine addiction is withdrawing from the drug. The family phones the clinic concerned about the client’s symptoms, which include excessive fatigue, sleeping, and a voracious appetite. Which of the following can the nurse instruct this family about the client’s symptoms?
- Prevent the client from eating.
B.* This is completely normal while withdrawing from this drug.
- Give the client hot black coffee to keep them awake.
- Try to keep the client awake and take to an emergency room if sleeping continues.
- MC The nurse sees a client with excessive lacrimation, rhinorrhea, yawning, and diaphoresis despite the cool temperature in the waiting room. Which of the following do these assessment findings suggest to the nurse?
- Amphetamine withdrawal.
B.* Heroin withdrawal.
- Marijuana withdrawal.
- Nicotine withdrawal.
- MC A client tells the nurse that she recalls “feeling funny” after taking a few sips of her drink at a night club and later remembers that she was raped. The nurse suspects that this client had been given:
- MC The nurse learns that there are multiple ways for organic inhalants to gain entry into the body. What are they? (Select all that apply.)
- MC A client tells the nurse that the new medication he is taking will cause him to be physically ill if he drinks with it. The nurse realizes this client has been prescribed:
- Fluoxetine (Prozac).
- Magnesium sulfate.
C.* Disulfiram (Antabuse).
- Naltrexone (ReVia).
- MC The nurse is interviewing a client who denies having a longstanding history of alcohol and drug use. Which of the following should the nurse do to gain information and direct care?
- Confront the client.
B.* Utilize the CAGE questionnaire.
- Refer to a psychologist.
- Request an inpatient evaluation.
- MC A client withdrawing from a drug is experiencing hallucinations. Which of the following nursing diagnoses would be appropriate for this client?
A.* Disturbed thought processes
- Imbalanced nutrition
- Low self-esteem
- Deficient knowledge
- MC The nurse in the emergency department is providing care to a client with a cocaine addiction. Which of the following terms are often used for cocaine? (Select all that apply.)
- Purple hearts
C.* White cloud