Question 1

The nurse makes a home visit to a client with chronic kidney disease.The client asks the nurse to make the decision about whether or not to start dialysis.Which action by the nurse is most appropriate?

A)Encourage the client to appoint a durable power of attorney.
B)Invite the client to make a decision after reviewing options.
C)Direct the client to have the physician make a decision.
D)Have the client visit with an individual receiving dialysis.

Accepted Answer

It is not within the scope of practice for a nurse to make healthcare decisions for a client. The nurse can provide the client with information and options related to dialysis, but the decision ultimately rests with the client. The nurse should invite the client to make an informed decision after reviewing all available options.

Question 2

Which describe characteristics of mutuality in the nurse-client relationship? Select all that apply.&#10;A)Dependency&#10;B)Collaboration&#10;C)Paternalism &#10;D)Acceptance of differences&#10;E)Empathy

Accepted Answer

Mutuality in the nurse-client relationship is founded on trust and respect, where both the nurse and the client work together to meet the client's needs. Collaboration, acceptance of differences, and empathy are key characteristics of mutuality, as the nurse-client relationship is based on mutual understanding and working towards the same goals. Dependency and paternalism are not characteristics of mutuality, as they involve power imbalances and can be detrimental to the client's autonomy and well-being.

Question 3

The nurse cares for a patient with urinary incontinence after a stroke.Which response by the nurse is best?&#10;A)&#34;You seem upset about this.We can work together on a bladder retraining program.&#34;&#10;B)&#34;I don't mind cleaning up your mess.I am used to it because my child does this at night.&#34;&#10;C)&#34;Don't be embarrassed.A lot of patients have this problem after a stroke.&#34;&#10;D)&#34;I will bring you some diapers to wear instead of having you wet the bed all the time.&#34;

Accepted Answer

The best response is to acknowledge the patient's feelings and offer a solution that involves working together on a bladder retraining program. This empowers the patient and shows the nurse's willingness to support them in managing their incontinence. Option B is inappropriate and unprofessional. Option C, while acknowledging the patient's experience, does not offer a solution. Option D is also inappropriate as it may be perceived as demeaning and disrespectful to the patient.

Question 4

The nurse cares for a patient who is scheduled for abdominal surgery.Which action,if taken by the nurse,is most appropriate?&#10;A)Mandate the use of a complementary therapy such as guided imagery.&#10;B)Administer opioids for pain rated more than 3 (on a 0-10 pain scale).&#10;C)Ask the patient about expectations for postoperative pain management.&#10;D)Provide pain management based on a standardized nursing care plan.

Accepted Answer

Asking the patient about expectations for postoperative pain management is important as it allows the nurse to individualize the pain management plan and incorporate the patient's preferences and expectations. This promotes patient-centered care and improves patient satisfaction. Mandating the use of a complementary therapy or administering opioids based solely on the pain rating may not be appropriate for all patients and can result in inadequate pain management. Providing pain management based on a standardized nursing care plan may not take into account the individual patient's needs and expectations.

Question 5

The nurse cares for a young adult patient in the emergency room after a sexual assault.Which action by the nurse is appropriate?&#10;A)Avoid situations in which the patient will be involved with decision making.&#10;B)Tell the patient to join a local support group for sexual assault victims.&#10;C)Actively listen to the patient express feelings related to the sexual assault.&#10;D)Provide detailed information about evidence collection and invasive procedures.

Accepted Answer

Actively listening to the patient express their feelings related to the sexual assault is an appropriate action as it allows the patient to process their emotions and feeling heard may be comforting. It is important to provide emotional support in addition to medical care to promote healing. Avoiding situations where the patient is involved with decision making would not be appropriate as the patient needs to be informed and make decisions about their care. Telling the patient to join a local support group may be appropriate, but it should not be the only action taken by the nurse. Providing detailed information about evidence collection and invasive procedures without properly assessing the patient's comfort level and emotional state may cause undue anxiety and re-traumatization.

Question 6

The nurse cares for a client who has several options for cancer treatment.Which document supports the client's right to have access to information about treatment options?&#10;A)Standards of Clinical Practice&#10;B)Advance Health Care Directive&#10;C)Patient's Bill of Rights&#10;D)Client's Living Will

Accepted Answer

The Patient's Bill of Rights lists the rights of patients, including the right to information about their diagnosis, treatment options, and potential outcomes. This document supports the client's right to access information about their cancer treatment options. Standards of Clinical Practice provide guidelines for healthcare professionals but do not directly support the client's rights. Advance Health Care Directives and Client's Living Wills are legal documents that outline a client's wishes for end-of-life care, but do not necessarily address access to information about treatment options.

Question 7

The nurse cares for a client with hypertension,and a nurse-client contract is developed outlining the activities and responsibilities of each.Which would be appropriate to include in this contract? Select all that apply.

A)The outcomes should be realistic and measurable.
B)Progress should be reviewed at regular intervals.
C)The contract should be written and signed.
D)The nurse should keep the information confidential.
E)The nurse and client should mutually evaluate progress.

Accepted Answer

These are all important elements of a nurse-client contract. The outcomes should be realistic and measurable so that progress can be tracked. Progress should be reviewed at regular intervals to ensure that the client is making progress towards their goals. The contract should be written and signed so that both the nurse and the client are clear on their responsibilities. The nurse should keep the information confidential to protect the client's privacy. The nurse and client should mutually evaluate progress to ensure that both parties are satisfied with the progress being made.

Question 8

The nurse cares for an adult client diagnosed with type 1 diabetes mellitus.Which is essential in building mutuality in the nurse-client relationship?&#10;A)The nurse controls the relationship by retaining the power to make judgments about diabetes education.&#10;B)The nurse teaches diabetes management by involving the client in making decisions about self-care.&#10;C)The nurse has expert knowledge of diabetes and formulates appropriate learning outcomes for the client.&#10;D)The nurse demonstrates trust and respect by solving problems for the client when issues occur with self-management.

Accepted Answer

Building mutuality in the nurse-client relationship involves promoting clients' autonomy and involving them in the decision-making process regarding their care. By involving the client in making decisions about their self-care, the nurse is promoting their independence and autonomy, which are essential in building a mutually beneficial relationship. Retaining power or making decisions for the client does not promote mutual trust and respect, and solving problems for the client may impede their ability to learn how to manage their diabetes independently. Expert knowledge is important, but it should be used to guide the client in making informed decisions about their care, rather than controlling the relationship.

Question 9

The home health nurse visits a client with heart failure who has increased dyspnea and peripheral edema and weight gain.The nurse suspects the client is not restricting fluids as prescribed.Which action by the nurse is most appropriate?

A)Teach the client about the consequences of not following the fluid restrictions.
B)Ask the client to report the amount of fluid intake for the past 24 hours.
C)Provide the client with sugarless candy or gum to decrease the thirst sensation.
D)Consult with the health care provider about increasing the dose of the diuretic.

Accepted Answer

Asking the client to report the amount of fluid intake for the past 24 hours will help the nurse confirm whether the client is following the fluid restrictions. This will also provide the nurse with valuable information to share with the healthcare provider for further management of the client's heart failure. Teaching the consequences of not following the fluid restrictions and providing sugarless candy or gum are not the most appropriate actions in this situation. Consulting with the healthcare provider about increasing the dose of the diuretic may be necessary, but this should only be done after confirming whether the client is following the fluid restrictions.

Question 10

The nurse discusses smoking cessation with a client.Which action,if taken by the nurse,would most likely result in a behavior change?&#10;A)The nurse should advise the client to contact the national telephone quitline.&#10;B)The nurse should recommend nicotine replacement and behavioral interventions.&#10;C)The nurse should collaborate with the client to develop an individualized plan of action.&#10;D)The nurse should implement a strategy that has been validated by research.

Accepted Answer

Collaborating with the client to develop an individualized plan of action takes into account the client's unique circumstances, preferences, and motivations, and can result in a behavior change that is more personal and meaningful to the client. This approach is more client-centered and empowering, compared to simply advising or recommending interventions that the client may not be fully committed to. The other options may also be helpful, but may not necessarily result in a behavior change without addressing the client's individual needs and preferences.

Deck 3: Solving Problems Together