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Exhibits

Which interventions are indicated to promote positive outcomes for the client? Select all that apply.

Acknowledge feelings of anxiety.

Weigh the client twice weekly.

Encourage exercise.

Provide family education on the condition.

Monitor trips to the restroom.

Allow for menu deviations.

Set precise mealtimes.

Answer and Explanation

Correct Answer : A,B,D,E,G

A. Acknowledge feelings of anxiety: The client's neurological assessment indicates agitation, and acknowledging this can help in addressing any underlying anxiety.
B. Weigh the client twice weekly: Given the client's low BMI and the mother's concern about her weight, regular monitoring is necessary.
C. Encourage exercise: While exercise is generally healthy, the client's current bradycardia and low BMI suggest that immediate physical exertion may not be advisable without medical
supervision.
D. Provide family education on the condition: The client's mother's concern and the client's defensiveness about her weight indicate a need for family education.
E. Monitor trips to the restroom: Monitoring is important to ensure the client is not engaging in behaviors that could further compromise her health, such as purging.
F. Allow for menu deviations is incorrect. Allowing menu deviations can enable the client to avoid certain foods, which reinforces disordered eating behaviors. Structured, balanced meals are essential for recovery.

G. Set precise mealtimes is correct because establishing structured mealtimes promotes consistency and reduces anxiety related to eating. This helps the client develop healthier eating patterns and decreases the urge to binge or purge.

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Correct Answer is A

Explanation

A. Observing the color of urine is crucial when monitoring for adverse effects of prasugrel, as one of the potential adverse effects is bleeding. Hematuria (blood in the urine) can indicate
bleeding complications, which require immediate attention.
B. Assessing skin turgor is not directly related to monitoring for adverse effects of prasugrel.
Skin turgor assessment is typically used to assess hydration status.
C. Measuring body temperature is important for monitoring for signs of infection or inflammation but is not directly related to monitoring for adverse effects of prasugrel.
D. Checking for pedal edema is not directly related to monitoring for adverse effects of
prasugrel. Pedal edema may indicate issues such as fluid overload or venous insufficiency.

A. "I can only give medical information to your child because the client is an adult." B. "I'm sorry, but your child's medical information is none of your business." C. "The healthcare provider will share this information with you." D. "I can give you those results as soon as I get them back from the lab."

Correct Answer is A

Explanation

Rationale for A: The Health Insurance Portability and Accountability Act (HIPAA) protects the privacy of medical information, and since the client is an adult, medical information can only be shared with the client or individuals the client designates. The nurse must follow these regulations and inform the parent appropriately.

Rationale for B: This response is inappropriate and disrespectful. While maintaining confidentiality is crucial, the language used should be sensitive and professional when discussing privacy issues with a parent.

Rationale for C: While the healthcare provider can discuss medical information, this response deflects responsibility. The nurse should clarify that medical information can only be shared with the client unless permission is granted.

Rationale for D: Offering to share lab results with the parent without the client's consent would violate HIPAA and the client's privacy rights, making this response incorrect.

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Exhibits Which interventions are indicated to promote positive outcomes for the client? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Following a cardiac catheterization and placement of a stent in the right coronary artery, the nurse administers prasugrel to the client. To monitor for adverse effects from the medication, which assessment is most important for the nurse to include in this client's plan of care?

Correct Answer is A

Explanation

A 22-year-old client is admitted to the hospital in diabetic ketoacidosis (DKA. The client's parent is insisting to know the laboratory test results. Which is the best response for the nurse to provide?

Correct Answer is A

Explanation

Exhibits Review History and Physical, and laboratory results. Based on the finding, indicate whether the finding represents a modifiable risk factor, a non modifiable risk factor, or is unrelated to type 2 diabetes mellitus.

A parent asked the nurse how to care for their 4-year-old child after receiving the Haemophilus influenzae type b (Hib) conjugate vaccine. Which instruction should the nurse provide?

A client at 10-weeks gestation reports a maculopapular rash on the face, fever, malaise, sore throat, and lymphadenopathy. Which laboratory result should the nurse review?

A client is being discharged home after being treated for heart failure (HF. Which instruction should the nurse include in this client's discharge teaching plan?

After receiving a change of shift report for clients on a medical surgical unit, which activity should the nurse delegate to the practical nurse (PN)?

Exhibits The nurse reviews the assessment findings along with the physician orders. Which immediate interventions would the nurse initiate? Select all that apply

An older adult male client arrives at the clinic reporting that his bladder always feels full. The client also reports a weak urine flow, frequent dribbling after voiding, and increasing nocturia with difficulty initiating the urine stream. Which action should the nurse implement?

Exhibits

Which interventions are indicated to promote positive outcomes for the client? Select all that apply.