A team of nurse case managers is implementing a nurse-led, community- based pain management program for a population of clients who have chronic pain and are underinsured. They are meeting today to discuss their progress.
Nurse 1
Nurse 2
Nurse 3
Nurse 4
Nurse 5
Correct Answer : C,D
A. Nurse 1: Sharing results of satisfaction surveys is part of the Evaluation phase (determining if the program worked), not Implementation.
B. Nurse 2: Generating an impact report on ED visits is also an Evaluation activity (measuring outcomes).
C. Nurse 3: "Met with clients to explain services" and "Discussed referral process" are active interventions. The nurse is executing the plan by connecting clients with resources.
D. Nurse 4: "Sent client referrals to providers" is an action. Implementation involves putting the plan into action, such as coordinating care and making referrals.
E. Nurse 5: Conducting an analysis of existing community resources is part of the Assessment phase (gathering data before planning).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
A. Schedule rest periods:The client's metabolism is "running a marathon," leading to exhaustion. Frequent rest lowers the metabolic demand on the heart.
B. Allow 1 month following radioactive iodine therapy for manifestations to subside:It typically takes 6 to 8 weeksor longer for the full effects of RAI therapy to manifest. One month may be too soon to expect full symptom resolution.
C. Flush the toilet with the lid closed:This is a specific precaution for clients receiving radioactive iodine (RAI)therapy. Since the radiation is excreted in body fluids (urine/stool), flushing with the lid closed prevents the aerosolization of radioactive particles.
D. Drink black tea to reduce diarrhea:Tea contains caffeine, a stimulant. Stimulants increase heart rate and metabolism, which are already dangerously high in this client.
E. Keep a record of food intake and weight:Due to the rapid weight loss, the nurse must monitor nutritional status to ensure the client is consuming enough calories (often a high-calorie diet is needed) to maintain weight.
Correct Answer is B
Explanation
A. "Clients who have glaucoma should not take warfarin." Glaucoma is not a contraindication for warfarin. Warfarin affects clotting factors, not intraocular pressure.
B. "Clients who are pregnant should not take warfarin." Warfarin (Coumadin) is a teratogen(Pregnancy Category X). It crosses the placenta and can cause fetal hemorrhage, spontaneous abortion, and severe congenital defects (fetal warfarin syndrome). Pregnant clients requiring anticoagulation are typically switched to Heparin or Enoxaparin (Lovenox), which do not cross the placenta.
C. "Clients who have hyperthyroidism should not take warfarin." While hyperthyroidism can increase the metabolism of clotting factors (potentially increasing the INR response), it is not a contraindication. The dose just needs to be monitored and adjusted closely.
D. "Clients who have rheumatoid arthritis should not take warfarin." Rheumatoid arthritis itself is not a contraindication. However, the nurse should warn the client about interacting medications often used for RA (like NSAIDs), which increase bleeding risk.
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