Question 1

The nurse is teaching a female client with chronic fatigue due to clinical depression regarding ways to increase energy levels.Which client statement indicates that teaching has been effective?&#10;A) &#34;I need to increase exercise time each week.&#34;&#10;B) &#34;I will spend time with friends.&#34;&#10;C) &#34;I will take Wellbutrin as prescribed.&#34;&#10;D) &#34;I will go shopping once a week.&#34;

Accepted Answer

A) Depression can cause chronic fatigue. Compliance with medications results in relief of depression and therefore increases energy levels. Shopping, spending time with friends, and increasing exercise levels will not help the client who is clinically depressed.
B) Depression can cause chronic fatigue. Compliance with medications results in relief of depression and therefore increases energy levels. Shopping, spending time with friends, and increasing exercise levels will not help the client who is clinically depressed.
C) Depression can cause chronic fatigue. Compliance with medications results in relief of depression and therefore increases energy levels. Shopping, spending time with friends, and increasing exercise levels will not help the client who is clinically depressed.
D) Depression can cause chronic fatigue. Compliance with medications results in relief of depression and therefore increases energy levels. Shopping, spending time with friends, and increasing exercise levels will not help the client who is clinically depressed.

Question 2

The nurse is preparing to assess comfort for several clients.Which will the nurse assess,in addition to the client's physical experience of pain,during this process? Select all that apply.&#10;A) Religion&#10;B) Friendship&#10;C) Environment&#10;D) Psychospirituality&#10;E) Social interaction

Accepted Answer

A) Comfort is the experience of having needs for relief and ease met in four contexts: physical, psychospiritual, social, and environmental. Religion and friendship are encompassed in psychospiritual and social.
B) Comfort is the experience of having needs for relief and ease met in four contexts: physical, psychospiritual, social, and environmental. Religion and friendship are encompassed in psychospiritual and social.
C) Comfort is the experience of having needs for relief and ease met in four contexts: physical, psychospiritual, social, and environmental. Religion and friendship are encompassed in psychospiritual and social.
D) Comfort is the experience of having needs for relief and ease met in four contexts: physical, psychospiritual, social, and environmental. Religion and friendship are encompassed in psychospiritual and social.
E) Comfort is the experience of having needs for relief and ease met in four contexts: physical, psychospiritual, social, and environmental. Religion and friendship are encompassed in psychospiritual and social.

Question 3

The nurse provides an in-service to peers regarding situations that can affect the comfort level of the clients on the unit.Which client statement indicates that the client's sense of well-being is negatively impacted?

A) "I feel like I have no energy today."
B) "I don't feel any physical pain today."
C) "I was able to sleep uninterrupted last night."
D) "I am so glad that playing cards takes my mind off my worries."

"I feel like I have no energy today."

Accepted Answer

A) When there is insufficient energy, the client is unable to focus on healing and lacks the ability to cope in stressful situations. Restful sleep, physical well-being, and appropriate diversion all promote a sense of comfort for the client.
B) When there is insufficient energy, the client is unable to focus on healing and lacks the ability to cope in stressful situations. Restful sleep, physical well-being, and appropriate diversion all promote a sense of comfort for the client.
C) When there is insufficient energy, the client is unable to focus on healing and lacks the ability to cope in stressful situations. Restful sleep, physical well-being, and appropriate diversion all promote a sense of comfort for the client.
D) When there is insufficient energy, the client is unable to focus on healing and lacks the ability to cope in stressful situations. Restful sleep, physical well-being, and appropriate diversion all promote a sense of comfort for the client.

Question 4

A client having difficulty sleeping asks the nurse what the complications of sleep deprivation might be.Which topic will the nurse include when responding to the client?&#10;A) Fatigue occurring at night&#10;B) Auditory hallucinations&#10;C) Improved wound healing&#10;D) Development of Alzheimer's disease

Accepted Answer

A) The client who is deprived of sleep may experience visual or auditory hallucinations. Sleep deprivation is not known to be a causative factor for Alzheimer's disease but is known to exacerbate behavioral problems in persons with Alzheimer's disease. Fatigue may occur but this is during the daytime. Delayed healing is associated with sleep deprivation.
B) The client who is deprived of sleep may experience visual or auditory hallucinations. Sleep deprivation is not known to be a causative factor for Alzheimer's disease but is known to exacerbate behavioral problems in persons with Alzheimer's disease. Fatigue may occur but this is during the daytime. Delayed healing is associated with sleep deprivation.
C) The client who is deprived of sleep may experience visual or auditory hallucinations. Sleep deprivation is not known to be a causative factor for Alzheimer's disease but is known to exacerbate behavioral problems in persons with Alzheimer's disease. Fatigue may occur but this is during the daytime. Delayed healing is associated with sleep deprivation.
D) The client who is deprived of sleep may experience visual or auditory hallucinations. Sleep deprivation is not known to be a causative factor for Alzheimer's disease but is known to exacerbate behavioral problems in persons with Alzheimer's disease. Fatigue may occur but this is during the daytime. Delayed healing is associated with sleep deprivation.

Question 5

A client reports feeling tired and not refreshed after sleeping even when everyone at home laughs about her loud snoring at night.What should the nurse suspect as being the cause of this client's fatigue?

A) Insomnia
B) Depression
C) Thyroid disorder
D) Sleep apnea

Accepted Answer

A) The client is snoring at home, which could indicate obstructive sleep apnea. Insomnia is the absence of sleep. There is not enough information to determine if the client is depressed or has a thyroid disorder.
B) The client is snoring at home, which could indicate obstructive sleep apnea. Insomnia is the absence of sleep. There is not enough information to determine if the client is depressed or has a thyroid disorder.
C) The client is snoring at home, which could indicate obstructive sleep apnea. Insomnia is the absence of sleep. There is not enough information to determine if the client is depressed or has a thyroid disorder.
D) The client is snoring at home, which could indicate obstructive sleep apnea. Insomnia is the absence of sleep. There is not enough information to determine if the client is depressed or has a thyroid disorder.

Question 6

A client is experiencing severe pain in the left lower quadrant of the abdomen that is rated as a 10 on a pain scale of 0-10.The client is also experiencing nausea,vomiting,and restlessness.Based on this data,the nurse concludes that the client is experiencing which phenomenon?

A) Acute pain
B) Chronic pain
C) End-of-life pain
D) Fibromyalgia pain

Accepted Answer

A) Acute pain is pain of varying severity, location, and etiology that 
Lasts fewer than 6 months. Acute pain is often manifested by nausea, vomiting, and restlessness. Chronic pain lasts longer than 6 months and persists beyond the expected period of healing. End-of-life pain is pain that is associated with the process of dying. Fibromyalgia pain is widespread muscular and joint pain. 
B) Acute pain is pain of varying severity, location, and etiology that 
Lasts fewer than 6 months. Acute pain is often manifested by nausea, vomiting, and restlessness. Chronic pain lasts longer than 6 months and persists beyond the expected period of healing. End-of-life pain is pain that is associated with the process of dying. Fibromyalgia pain is widespread muscular and joint pain. 
C) Acute pain is pain of varying severity, location, and etiology that 
Lasts fewer than 6 months. Acute pain is often manifested by nausea, vomiting, and restlessness. Chronic pain lasts longer than 6 months and persists beyond the expected period of healing. End-of-life pain is pain that is associated with the process of dying. Fibromyalgia pain is widespread muscular and joint pain. 
D) Acute pain is pain of varying severity, location, and etiology that 
Lasts fewer than 6 months. Acute pain is often manifested by nausea, vomiting, and restlessness. Chronic pain lasts longer than 6 months and persists beyond the expected period of healing. End-of-life pain is pain that is associated with the process of dying. Fibromyalgia pain is widespread muscular and joint pain.

Question 7

An Asian man brings his wife to the clinic and states,"I want you to fix my wife and tell her that there is nothing wrong with her." The client has symptoms of pain,sleep disorders,and stiffness.Which would be most appropriate for the nurse to include in a plan of care for this family?

A) Medications used to treat fibromyalgia
B) An exercise program to increase energy
C) Information and literature on fibromyalgia
D) Suggested dietary changes to help with the pain

Accepted Answer

A) In many cultures, accepting a disease like fibromyalgia may be difficult due to the vagueness of the disease. Information and written literature may help the family understand that the disease is real. The physician orders medication and diets. There is no proof that exercise, or lack thereof, causes fibromyalgia.
B) In many cultures, accepting a disease like fibromyalgia may be difficult due to the vagueness of the disease. Information and written literature may help the family understand that the disease is real. The physician orders medication and diets. There is no proof that exercise, or lack thereof, causes fibromyalgia.
C) In many cultures, accepting a disease like fibromyalgia may be difficult due to the vagueness of the disease. Information and written literature may help the family understand that the disease is real. The physician orders medication and diets. There is no proof that exercise, or lack thereof, causes fibromyalgia.
D) In many cultures, accepting a disease like fibromyalgia may be difficult due to the vagueness of the disease. Information and written literature may help the family understand that the disease is real. The physician orders medication and diets. There is no proof that exercise, or lack thereof, causes fibromyalgia.

Question 8

A participant in a seminar given by the nurse asks for information about lifestyle situations that might contribute to chronic fatigue.Which should the nurse identify in response to this request? Select all that apply.

A) Synthroid use
B) Chronic back pain
C) Marijuana use
D) Vigorous exercise three times a week
E) Swimming after a meal

Accepted Answer

A) Fatigue is a symptom that needs investigating. Some risk factors for fatigue are hypothyroidism, use of drugs such as marijuana, and chronic pain. Synthroid use indicates hypothyroidism. Swimming and vigorous exercise will energize, not produce fatigue.
B) Fatigue is a symptom that needs investigating. Some risk factors for fatigue are hypothyroidism, use of drugs such as marijuana, and chronic pain. Synthroid use indicates hypothyroidism. Swimming and vigorous exercise will energize, not produce fatigue.
C) Fatigue is a symptom that needs investigating. Some risk factors for fatigue are hypothyroidism, use of drugs such as marijuana, and chronic pain. Synthroid use indicates hypothyroidism. Swimming and vigorous exercise will energize, not produce fatigue.
D) Fatigue is a symptom that needs investigating. Some risk factors for fatigue are hypothyroidism, use of drugs such as marijuana, and chronic pain. Synthroid use indicates hypothyroidism. Swimming and vigorous exercise will energize, not produce fatigue.
E) Fatigue is a symptom that needs investigating. Some risk factors for fatigue are hypothyroidism, use of drugs such as marijuana, and chronic pain. Synthroid use indicates hypothyroidism. Swimming and vigorous exercise will energize, not produce fatigue.

Question 9

The nurse is caring for a dying child.Which nursing action supports the primary goal for a dying child?&#10;A) Keep the child entertained so she does not think about dying.&#10;B) Ensure that a good relationship is maintained with the family.&#10;C) Administer pain medication as ordered.&#10;D) Maintain a busy schedule for child and family members.

Accepted Answer

A) The major goal for the dying child is to promote comfort and keep the child pain-free by providing analgesia to promote optimal pain relief. Maintaining a good relationship is important but not a major goal for the child's care. Keeping the child entertained is good, but the client needs to voice her feelings about death and dying. A dying child does not have the energy to maintain a busy schedule.
B) The major goal for the dying child is to promote comfort and keep the child pain-free by providing analgesia to promote optimal pain relief. Maintaining a good relationship is important but not a major goal for the child's care. Keeping the child entertained is good, but the client needs to voice her feelings about death and dying. A dying child does not have the energy to maintain a busy schedule.
C) The major goal for the dying child is to promote comfort and keep the child pain-free by providing analgesia to promote optimal pain relief. Maintaining a good relationship is important but not a major goal for the child's care. Keeping the child entertained is good, but the client needs to voice her feelings about death and dying. A dying child does not have the energy to maintain a busy schedule.
D) The major goal for the dying child is to promote comfort and keep the child pain-free by providing analgesia to promote optimal pain relief. Maintaining a good relationship is important but not a major goal for the child's care. Keeping the child entertained is good, but the client needs to voice her feelings about death and dying. A dying child does not have the energy to maintain a busy schedule.

Question 10

The nurse is taking care of a client with terminal lung cancer who is showing signs of imminent death.What changes should the nurse expect the client to exhibit? Select all that apply.&#10;A) Decreased blood pressure&#10;B) Initial increased heart rate followed by bradycardia&#10;C) An increase in the volume of Korotkoff's sounds&#10;D) Diaphoresis&#10;E) An increase in cardiac output

Accepted Answer

A) The heart rate might initially increase as hypoxia develops; then the heart rate and blood pressure decrease, resulting in decreased cardiac output. Peripheral circulation decreases, leading to diaphoresis; clammy, cool skin; and changes in skin coloring. A change in pulse pressure and a decrease in the volume of Korotkoff's sounds indicate imminent death. The heart rate and blood pressure decrease, resulting in decreased cardiac output, which is a sign of imminent death.
B) The heart rate might initially increase as hypoxia develops; then the heart rate and blood pressure decrease, resulting in decreased cardiac output. Peripheral circulation decreases, leading to diaphoresis; clammy, cool skin; and changes in skin coloring. A change in pulse pressure and a decrease in the volume of Korotkoff's sounds indicate imminent death. The heart rate and blood pressure decrease, resulting in decreased cardiac output, which is a sign of imminent death.
C) The heart rate might initially increase as hypoxia develops; then the heart rate and blood pressure decrease, resulting in decreased cardiac output. Peripheral circulation decreases, leading to diaphoresis; clammy, cool skin; and changes in skin coloring. A change in pulse pressure and a decrease in the volume of Korotkoff's sounds indicate imminent death. The heart rate and blood pressure decrease, resulting in decreased cardiac output, which is a sign of imminent death.
D) The heart rate might initially increase as hypoxia develops; then the heart rate and blood pressure decrease, resulting in decreased cardiac output. Peripheral circulation decreases, leading to diaphoresis; clammy, cool skin; and changes in skin coloring. A change in pulse pressure and a decrease in the volume of Korotkoff's sounds indicate imminent death. The heart rate and blood pressure decrease, resulting in decreased cardiac output, which is a sign of imminent death.
E) The heart rate might initially increase as hypoxia develops; then the heart rate and blood pressure decrease, resulting in decreased cardiac output. Peripheral circulation decreases, leading to diaphoresis; clammy, cool skin; and changes in skin coloring. A change in pulse pressure and a decrease in the volume of Korotkoff's sounds indicate imminent death. The heart rate and blood pressure decrease, resulting in decreased cardiac output, which is a sign of imminent death.

Question 11

A competent older adult client has a living will that expresses the client's desire to avoid resuscitation and heroic life support measures.The family members are not supportive of this directive and plan to contest the living will.Which nursing action is the most appropriate?

A) Place the document on the chart.
B) Contact the Social Services department.
C) Explain to the client that the conflict could invalidate the document.
D) Notify the hospital attorney.

Accepted Answer

The answer of A competent older adult client has a...

Question 12

A client with clinical depression asks the nurse for suggestions on how to improve the quality of sleep.After reviewing the client's history,which suggestion by the nurse is the most appropriate? Select all that apply.

A) Avoid the use of alcohol late in the evening.
B) Consume a cup of tea before bed to relax.
C) Adjust the temperature in the room to a comfortable level.
D) Change the time of aerobic exercise to 1 hour prior to sleep.
E) Avoid smoking before bedtime.

Accepted Answer

The answer of A client with clinical depression asks the...

Question 13

An adult client is diagnosed with fibromyalgia.The client asks the nurse whether a recent of infection with the Coxsackie B virus could have caused fibromyalgia.Which response by the nurse is the most appropriate?

A) The Coxsackie B virus has nothing to do with fibromyalgia.
B) The Coxsackie B virus may have triggered the fibromyalgia.
C) The Coxsackie virus definitely caused the fibromyalgia.
D) Fibromyalgia is a psychiatric disorder.

Accepted Answer

The answer of An adult client is diagnosed with fibromyalgia.The...

Question 14

An adult client diagnosed with sleep apnea has been prescribed a continuous positive airway pressure (CPAP)machine as treatment.The nurse is instructing the client on how to use the machine.Which instruction should the nurse include?

A) Any size mask will work.
B) Straps can be loose, if that feels more comfortable.
C) Use relaxation exercises to reduce uncomfortable feelings from the mask.
D) Do not use a humidifier at the same time.

Accepted Answer

The answer of An adult client diagnosed with sleep apnea...

Question 15

A female client has returned to the unit following a hysterectomy.The nurse knows that which intervention will provide the most pain relief for the client?&#10;A) Offer pain relief before the client complains of pain.&#10;B) Assess the pain level every 4 hours around the clock.&#10;C) Wait until the client can describe the pain specifically.&#10;D) Allow the client to &#34;sleep off&#34; the anesthesia, and then offer pain medication.

Accepted Answer

The answer of A female client has returned to the...

Question 16

A resident in an assisted-living facility is restless most nights and sits in the lounge area reading.When questioned,the resident reports suffering from insomnia.What should the nurse expect as an outcome if the resident continues with this pattern of sleep?

A) Safety issues with an unsupervised resident in the lounge area
B) Onset of cardiac dysfunction
C) Onset of new underdiagnosed health problems
D) The ability to function during the day may be hindered by these episodes.

Accepted Answer

The answer of A resident in an assisted-living facility is...

Question 17

The nurse is caring for a client who is diagnosed with fibromyalgia.Based on this diagnosis,which clinical manifestations does the nurse anticipate for this client? Select all that apply.&#10;A) Irritable bowel syndrome&#10;B) Insomnia&#10;C) Pain in the calves of the leg&#10;D) Nausea and vomiting&#10;E) Anxiety

Accepted Answer

The answer of The nurse is caring for a client...

Question 18

The nurse is teaching a class on the perception of pain.What will the nurse teach as being the second step in processing pain stimuli?&#10;A) Thalamus&#10;B) Reticular system&#10;C) Limbic system&#10;D) Cerebral cortex

Accepted Answer

The answer of The nurse is teaching a class on...

Deck 3: Comfort