A nurse mistakenly gave a client who was NPO a morning breakfast tray. After realizing the mistake, the nurse notified the physician as well as the client; explained the consequences of this mistake, which included a delay in the client's scheduled procedure; and documented the situation in the client's medical record. What did this nurse demonstrate?

Altruism

Human dignity

Social justice

Integrity

Answer and Explanation

The Correct Answer is D

In this situation, the nurse demonstrated integrity. After realizing the mistake of giving a client who was NPO a morning breakfast tray, the nurse took responsibility for the mistake by notifying the physician and the client, explaining the consequences of the mistake, and documenting the situation in the client's medical record. The other options (Altruism, Human dignity, and Social justice) are not directly related to this situation.

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Correct Answer is C

Explanation

During the introductory (orientation) phase of the nurse-client relationship, the nurse should focus on establishing trust and rapport with the client. One way to do this is by eliciting information from the client through active listening and open-ended questioning. This allows the nurse to gather important information about the client's health status, needs, and concerns and helps to establish a foundation for the therapeutic relationship. Reviewing progress toward personal objectives and encouraging self-exploration is more appropriate for later phases of the relationship.

Talking with others who have information about the client may also be helpful, but it is important to prioritize direct communication with the client during this phase.

A. Reposition the client every 3 hours. B. Apply cornstarch to keep the skin dry. C. Provide the client with a diet high in protein. D. Massage bony prominences to promote circulation.

Correct Answer is C

Explanation

A diet high in protein can help maintain skin integrity in older adults. Protein is essential for tissue repair and wound healing. The other options may not be as effective in maintaining skin integrity. For example, repositioning the client every 3 hours may not be frequent enough to prevent pressure ulcers. Applying cornstarch to keep the skin dry may not be the best option as it is important to keep the skin moisturized. Massaging bony prominences to promote circulation may not be recommended as it could cause damage to fragile skin.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in the introductory (orientation) phase of the nurse-client relationship. Which of the following communication techniques should the nurse use during this phase?

Correct Answer is C

Explanation

A nurse is caring for an older adult client who is at risk for skin breakdown. The nurse should use which of the following interventions to help maintain the integrity of the client's skin?

Correct Answer is C

Explanation

The attributes of a professional nurse are:

A client visits a health care facility reporting loss of appetite following a prolonged illness. How should the nurse document the client's condition?

A nurse is assessing a client who has a fever, an infection of a ﬂank incision, and is in severe pain. Which type of pulse rate would the client most likely exhibit?

The client who has sleep apnoea reports falling asleep while driving, almost being involved in an accident, and frequent episodes of sleepwalking. What nursing diagnosis should be a priority for this client?

During an assessment, a client who is not very talkative appears pale, diaphoretic, and restless in the bed and says "leave me alone." Which subjective data should the nurse document?

A nurse enters a client's room and sees that ashes from a cigarette are beginning to ignite trash in the wastebasket. What actions should the nurse take first?

A nurse is conducting a lung assessment on a client suspected of having pneumonia. Which finding should the nurse report to the physician immediately?

While conducting a dressing change, the nurse notes a new area of skin breakdown that was caused by the tape used to secure the dressing. In which phase of the nursing process is the nurse working?