The nurse is assisting in the care of a patient after open-heart surgery. Which action by the other nurse would warrant intervention?

Providing the patient with a pillow to brace the incision

Instructing the patient to perform deep coughing every 30 minutes

Having the patient sit up and lean forward

Giving pain medication prior to coughing

Answer and Explanation

The Correct Answer is B

Choice A reason: Providing a pillow to brace the incision is a recommended practice to support the incision during coughing or movement.

Choice B reason: Instructing the patient to perform deep coughing every 30 minutes is a standard postoperative care practice to prevent atelectasis.

Choice C reason: Having the patient sit up and lean forward can help with breathing and comfort after surgery.

Choice D reason: Giving pain medication prior to coughing is actually a recommended practice to reduce pain and facilitate effective coughing.

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Correct Answer is D

Explanation

Choice A reason: OCD is not characterized by an unconscious need to manipulate others but by anxiety-driven compulsions.

Choice B reason: While clients with OCD may feel a need to clean due to contamination fears, it is not a delusion but rather an obsession that drives the compulsion.

Choice C reason: The repetitive cleaning is not typically a conscious choice to decrease social interaction but a compulsion to alleviate anxiety.

Choice D reason: Repetitive behaviors in OCD, such as cleaning, are attempts to decrease the anxiety caused by obsessive thoughts.

A. Thinking/content of thought. B. Memory. C. Judgment. D. Speech and the ability to communicate.

Correct Answer is A

Explanation

Choice A reason: The 'thinking/content of thought' section of the Mental Health Status Examination assesses the logical process of thought, presence of delusions, obsessions, and preoccupations.

Choice B reason: 'Memory' assesses the person's ability to recall past events, which is not directly related to their current thought content.

Choice C reason: 'Judgment' evaluates the ability to make reasoned decisions, which, while important, is distinct from the content of thought.

Choice D reason: 'Speech and the ability to communicate' assesses the clarity, relevance, and coherence of speech, not the internal thought process.

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The nurse is assisting in the care of a patient after open-heart surgery. Which action by the other nurse would warrant intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has obsessive-compulsive disorder (OCD) and observes that the client demonstrates constant repetitive cleaning. The nurse should realize that the client's repetitive behaviors occur due to which of the following?

Correct Answer is D

Explanation

In the Mental Health Status Examination, which of the following focuses on what the person is thinking?

Correct Answer is A

Explanation

A client with COPD should receive only 1-2 liters per minute of oxygen, if needed, or they may lose their hypoxic drive. Which of the following statements is correct about hypoxic drive?

Which of the following is a priority when caring for a highly anxious patient?

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A general goal for a patient with a Personality Disorder is:

A nurse is reinforcing preoperative teaching to a client who is undergoing total hip replacement surgery. Which of the following statements should the nurse include in the teaching?

A nurse is caring for a client who has obsessive-compulsive disorder (OCD) and is constantly picking up after others and cleaning in the day room. The nurse should recognize the client's actions as which of the following?