Which client is best to assign to the practical nurse (PN) who is assisting the registered nurse (RN) with the care of a group of clients?

An adult who is one day postoperative for a laparoscopic cholecystectomy.

An older client who is one day postoperative with a colostomy for colon cancer.

An older adult who is scheduled for foot amputation due to diabetes complications.

An adult with alcoholism, cirrhosis, and hepatic encephalopathy.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Assigning a client who is one day postoperative for a laparoscopic cholecystectomy to the practical nurse (PN) is appropriate. This procedure is minimally invasive, and the client is likely stable, requiring routine postoperative care such as wound assessment, pain management, and monitoring for any signs of complications.

Choice B rationale:

An older client who is one day postoperative with a colostomy for colon cancer may have complex postoperative needs, including colostomy care, monitoring for complications, and pain management. This level of care is usually within the scope of the registered nurse (RN) rather than a practical nurse (PN).

Choice C rationale:

An older adult who is scheduled for foot amputation due to diabetes complications is likely to have complex care needs, including wound care, diabetes management, and potential complications. This client would require the expertise of an RN rather than a PN.

Choice D rationale:

An adult with alcoholism, cirrhosis, and hepatic encephalopathy may have complex medical and psychosocial issues that require specialized nursing care. This client's condition is not appropriate for a practical nurse (PN) to manage, and the care should be provided by an RN or other specialized healthcare provider.

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Correct Answer is C

Explanation

Choice A rationale:

Addiction involves a dependence on a substance or behavior that leads to withdrawal symptoms when the substance or behavior is discontinued. The client's handwashing behavior is not related to addiction.

Choice B rationale:

Phobia refers to an irrational and intense fear of a specific object or situation. While the client's avoidance of sitting on chairs in the day area may be related to anxiety, it does not represent a specific phobia.

Choice C rationale:

Compulsion is the correct answer because the client's handwashing ritual is an example of compulsive behavior. Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession or according to rigid rules. In this case, the client is compelled to engage in the ritual to alleviate anxiety or distress.

Choice D rationale:

Obsession refers to persistent and intrusive thoughts, urges, or images that cause distress and anxiety. While the client's handwashing ritual may be related to obsessive thoughts about cleanliness, the primary clinical behavior being exhibited is the compulsive handwashing itself.

A. Refer client to the social worker for support therapy. B. Encourage client to implement relaxation techniques. C. Leave the client's room and return later in the day. D. Explain that insulin is a life-saving drug for the client. E. Explain that insulin is a life-saving drug for the client.

Correct Answer is C

Explanation

Choice A rationale:

Referring the client to a social worker for support therapy may be premature at this stage. The client's initial reaction may be due to fear or anxiety about the diagnosis and self-administration of insulin. Pushing the client into therapy without assessing their readiness may not be appropriate.

Choice B rationale:

Encouraging the client to implement relaxation techniques assumes that the client is open to learning and just needs help with anxiety management. However, the client's refusal to have the nurse in the room suggests that they are not currently receptive to teaching. It's important to address the client's emotional state first.

Choice C rationale:

Leaving the client's room and returning later in the day is the most appropriate initial action. The client's loud refusal indicates a need for privacy and emotional space. By respecting the client's wishes and revisiting the teaching later, the nurse can establish trust and build a better rapport.

Choice D rationale:

Explaining that insulin is a life-saving drug is informative but may not be effective in this situation, as the client has already requested the nurse to leave the room. Providing information about the importance of insulin should come after establishing a therapeutic nurse-client relationship.

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Which client is best to assign to the practical nurse (PN) who is assisting the registered nurse (RN) with the care of a group of clients?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

When the nurse attempts to teach self-administration of insulin injections to a client who is newly diagnosed with type 1 diabetes mellitus (DM), the client tells the nurse in a loud voice to leave the room. Which action should the nurse take?

Correct Answer is C

Explanation

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