client education by the nurse entails

NCLEX-PN

Nclex Questions Management of Care

1. What is involved in client education by the nurse?

A. Telling the client everything about their disease, what will happen in the course of the disease, and the outcome.
B. Giving information to the client that is accurate and understandable.
C. Informing the client that the pain they experience might not be real.
D. Administering medication to the client when they experience pain.

Correct answer: B

Rationale: Client education by the nurse involves providing accurate and understandable information to the client. It is essential to offer relevant details without overwhelming them, making choice B the correct answer. Choice A is incorrect because providing excessive details can confuse the client rather than empower them with necessary knowledge. Choice C is incorrect as it is not the role of the nurse to question the reality of a client's pain; instead, they should address and manage the pain effectively. Choice D is incorrect as client education focuses on providing information and empowering clients with knowledge, not just administering medication.

2. Which of the following neurological disorders is characterized by writhing, twisting movements of the face and limbs?

A. epilepsy
B. Parkinson's
C. multiple sclerosis
D. Huntington's chorea

Correct answer: D

Rationale: Huntington's chorea is a neurological disorder characterized by writhing, twisting movements of the face and limbs, known as chorea. Epilepsy is characterized by seizures, not writhing, twisting movements. Parkinson's disease presents with tremors, rigidity, and bradykinesia, not writhing, twisting movements. Multiple sclerosis affects the central nervous system but does not typically involve writhing, twisting movements. Therefore, the correct answer is Huntington's chorea as it specifically manifests with these characteristic movements.

3. The client asks the nurse not to tell anyone outside of the care team about his positive HIV diagnosis. What response is most appropriate?

A. "I have to inform all clients on the unit of your diagnosis as it is transmissible."?
B. "I will not communicate your diagnosis to anyone without your permission."?
C. "Because this is a communicable disease, it may need to be reported to the CDC."?
D. "You should not be concerned with who I share your diagnosis with."?

Correct answer: C

Rationale: The most appropriate response is C: "Because this is a communicable disease, it may need to be reported to the CDC."? It is important to uphold patient confidentiality, but in the case of certain communicable diseases like HIV, there are legal requirements for mandatory reporting to public health authorities such as the CDC. Option A is incorrect because it violates patient confidentiality and does not consider legal obligations. Option B, while respecting the client's wishes, may not align with the legal requirement for reporting certain communicable diseases. Option D is inappropriate as it dismisses the client's concerns and rights regarding their health information.

4. When observing a dressing change by a graduate nurse on a Stage III pressure ulcer to the greater trochanter by the staff nurse, a need for further teaching is indicated after the following observation by the nurse:

A. The new graduate nurse irrigates the pressure ulcer with 50cc of NS.
B. The new graduate irrigates the pressure ulcer with half-strength hydrogen peroxide.
C. The new graduate packs the wound with sterile kerlix soaked in NS.
D. The new graduate applies a Duoderm dressing over the wound after cleansing.

Correct answer: B

Rationale: The correct answer is that the new graduate irrigates the pressure ulcer with half-strength hydrogen peroxide. Pressure ulcers should not be cleaned with substances that are cytotoxic, such as hydrogen peroxide or betadine. This can cause further damage to the wound and delay the healing process. Choice A is incorrect because irrigating the pressure ulcer with normal saline is an appropriate practice. Choice C is incorrect because packing the wound with sterile kerlix soaked in normal saline is also an appropriate step. Choice D is incorrect because applying a Duoderm dressing after cleansing is a standard procedure in wound care.

5. A gastroenterologist should be consulted for clients suffering from:

A. digestive system diseases
B. urinary system diseases
C. female reproductive system diseases
D. nervous system diseases

Correct answer: A

Rationale: A gastroenterologist specializes in treating diseases and disorders of the digestive system, including the stomach, intestines, liver, and pancreas. Therefore, clients with digestive system diseases should consult a gastroenterologist. Choices B, C, and D are incorrect because urinary system diseases are managed by urologists, female reproductive system diseases by gynecologists, and nervous system diseases by neurologists.