1. A nurse in a provider’s office is preparing to assess a young adult male client’s musculoskeletal system as part of a comprehensive physical examina... [Show More] tion. Which of the following findings should the nurse expect? (Select all that apply.) A. A concave thoracic spine posteriorly B. An exaggerated lumbar curvature C. A concave lumbar spine posteriorly D. An exaggerated thoracic curvature E. Muscles slightly larger on his dominant side 2. A nurse is evaluating a client’s neurosensory system. To evaluate stereognosis, she should ask the client to close his eyes and identify which of the following items? A. A word she whispers 30 cm from his ear B. A number she traces on the palm of his hand C. The vibration of a tuning fork she places on his foot D. A familiar object she places in his hand 3. A nurse is assessing a client who reports pain when the nurse evaluates the internal rotation of her right shoulder. Which of the following activities is this problem likely to affect? A. Mopping her floors B. Brushing the back of her hair C. Fastening her bra behind her back D. Reaching into a cabinet above her sink 4. A nurse is performing a neurosensory examination for a client. Which of the following tests should the nurse perform to test the client’s balance? (Select all that apply.) A. Romberg test B. Heel-to-toe walk C. Snellen test D. Spinal accessory function E. Rosenbaum test CHAPTER 31 musCuloskeletal and neurosensory systems Fundamentals For nursing 303 5. A nurse is collecting data from an older adult client as part of a neurosensory examination. Which of the following findings should the nurse expect as changes associated with aging? (Select all that apply.) A. Slower light touch sensation B. Some vision and hearing decline C. Slower fine finger movement D. Some short-term memory decline E. Slower superficial pain sensation CHAPTER 32 tHeraPeutiC CommuniCation Fundamentals For nursing 313 APPLICATION EXERCISES 1. A nurse is caring for a client who states, “I have to check with my wife and see if she thinks I am ready to be discharged.” The nurse replies, “How do you feel about going home today?” Which clarifying technique is the nurse displaying to enhance communication between the nurse and the client? A. Pacing B. Reflecting C. Paraphrasing D. Restating 2. A nurse is caring for a client who is concerned about being discharged home with a new colostomy because he is an avid swimmer. Which of the following statements made by the nurse indicates use of an effective communication technique? (Select all that apply.) A. “You will do great! You just have to get used it.” B. “Why are you worried about going home?” C. “Your daily routines will be different when you get home.” D. “Tell me about your support system when you leave the hospital.” E. “Let me tell you about a friend of mine with a colostomy who also enjoys swimming.” 3. A nurse recognizes that a helping relationship is established with a client if the communication A. is equally reciprocal between the nurse and the client. B. encourages the client to express his thoughts and feelings. C. has no time limits. D. occurs spontaneously throughout the nurse-client relationship. 4. A nurse is caring for a school-age child who is seated. In order to facilitate effective communication, the nurse should A. touch the child. B. sit at eye level with the child. C. stand facing the child. D. stand with a relaxed posture. CHAPTER 32 tHeraPeutiC CommuniCation 314 Fundamentals For nursing 5. Which of the following are behaviors of active listening? (Select all that apply.) A. Maintaining an open posture B. Writing down what the client says so that details are not forgotten C. Establishing and maintaining eye contact D. Nodding in agreement with the client throughout the conversation E. Responding positively when giving feedback CHAPTER 33 CoPing Fundamentals For nursing 323 APPLICATION EXERCISES 1. A nurse is caring for a client whose partner passed away 4 months ago and who has been recently diagnosed with diabetes mellitus. He is tearful and states, “How could you possibly understand what I am going through?” Which of the following is an appropriate response by the nurse? A. “It takes time to get over the loss of a loved one.” B. “You are right; I cannot really understand. Perhaps you’d like to tell me more about what you’re feeling.” C. “Why don’t you try something to take your mind off your troubles, like watching a funny movie.” D. “I might not share your exact situation, but I do know what people go through when they deal with a loss.” 2. A nurse is caring for a client awaiting transport to the surgical suite for a coronary artery bypass graft. Just as the transport team arrives, the nurse takes the client’s vital signs and notes an elevation in blood pressure and heart rate. The nurse should recognize this response as which part of the general adaptation syndrome (GAS)? A. Exhaustion stage B. Resistance stage C. Alarm reaction D. Recovery reaction 3. A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following nursing interventions for stress, coping, and adherence to the treatment plan would be appropriate at this time? (Select all that apply.) A. Suggest coping skills for the client to utilize in this situation. B. Allow the client to provide input in the treatment plan. C. Assist the client with time management, and address the client’s priorities. D. Provide extensive instructions on the client’s treatment regimen. E. Encourage the client in the expression of feelings and concerns. 4. A nurse is caring for a client who has left-sided hemiplegia resulting from a cerebrovascular accident. The client works as a carpenter and is now experiencing a situational role change based on physical limitations. The client is the primary wage earner in the family. Which of the following best describes the client’s role problem? A. Role conflict B. Role overload C. Role ambiguity D. Role strain CHAPTER 33 CoPing 324 Fundamentals For nursing 5. Which of the following approaches should the nurse use when working with a family using an open structure for coping with crisis? A. Prescribing tasks unilaterally B. Delegating care to one member C. Speaking to the primary client privately D. Convening a family meeting CHAPTER 34 selF-ConCePt and seXuality 1. A nurse in an ambulatory care clinic is caring for a client who had a mastectomy 6 months ago. The client tells the nurse that she has not had much desire for sexual relations since her surgery, stating, “My body is so different now.” Which of the following is an appropriate response by the nurse? A. “Really, you look just fine to me. There’s no need to feel undesirable.” B. “I’m interested in finding out more about how your body feels to you.” C. “Consider an afternoon at a spa. A facial will make you feel more attractive.” D. “It’s still too soon to expect to feel normal. Give it a little more time.” 2. A nurse is caring for a group of clients on a medical-surgical unit. Which of the following clients are at high risk for body image disturbances? (Select all that apply.) A. 30-year-old male following laparoscopic appendectomy B. 45-year-old female following mastectomy C. 20-year-old female following lef t above-the-knee amputation D. 65-year-old male following cardiac catheterization E. 55-year-old male following stroke with right-sided hemiplegia 3. A nurse is caring for a client who is 3 days postoperative following a below-the-knee amputation as a result of a motor vehicle crash. Which of the following client statements indicates to the nurse that the client has a distorted body image? A. “I’ll be able to function exactly as I did before the accident.” B. “I just can’t stop crying.” C. “I am so mad at that guy who hit us. I wish he lost a leg.” D. “I don’t even want to look at my leg. You can check the dressing.” 4. A nurse is caring for a client who is recovering from a myocardial infarction and a cardiac catheterization. The client states, “I am concerned that things might be a little, you know, ‘different’ with my wife when I get home.” Which of the following statements is an appropriate response by the nurse? A. “Sounds like something you should discuss with her when you get home.” B. “It sounds like you are concerned about sexual functioning. Let’s discuss your concerns.” C. “Oh, I wouldn’t be too concerned. Things will be fine as soon as we get you home.” D. “Just make sure you take your medication as directed, and you should be fine.” CHAPTER 34 selF-ConCePt and seXuality Fundamentals For nursing 331 5. A nurse is teaching a group of clients how to care for their colostomies. Which of the following statements should alert the nurse that one of the clients is having an issue with self-concept? A. “I was having difficulty with attaching the appliance at first, but my wife was able to help.” B. “I’ll never be able to care for this at home. Can’t you just send a nurse to the house?” C. “I met a neighbor who also has a colostomy, and he taught me a few things.” D. “It may take me a while to get the hang of this. I have to admit, I am pretty nervous.” CHAPTER 35 Cultural and sPiritual nursing Care Fundamentals For nursing 343 APPLICATION EXERCISES 1. A nurse is using an interpreter to communicate with a client. Which of the following are appropriate when communicating with a client and his family? (Select all that apply.) A. Talk to the interpreter about the family while the family is in the room. B. Ask the family one question at a time. C. Look at the interpreter when asking the family questions. D. Use lay terms if possible. E. Do not interrupt the interpreter and the family as they talk. 2. A nurse is caring for a client who shares the same religious background. The nurse should recognize that A. members of the same religion share similar feelings about their religion. B. a shared religious background generates mutual regard for one another. C. the same religious beliefs may influence individuals differently. D. they should discuss the differences and commonalities in their beliefs. 3. A nurse is caring for a client who is crying while reading from his devotional book. Which of the following interventions is appropriate for the nurse to take? A. Contact the hospital’s spiritual services. B. Ask him what is making him cry. C. Provide quiet times for these moments. D. Turn on the television for a distraction. 4. A nurse is planning care for a client who is a devout Muslim and is 3 days postoperative following a hip arthroplasty. The client is scheduled for two physical therapy sessions today. Which of the following statements by the nurse indicates culturally appropriate care to the Muslim client? A. “I will make sure the menu includes kosher options.” B. “I will discuss the daily schedule with the client to make sure the client will have time for prayer.” C. “I will make sure to use direct eye contact when speaking with this client. ...... [Show Less]
