Nursing Elites

1. A client with stage IV lung cancer is 3 days postoperative following a wedge resection. The client states, “I told myself that I would go through with the surgery and quit smoking, if I could just live long enough to attend my child’s wedding.” Based on the Kubler-Ross model, which stage of grief is the client experiencing?

• A. Anger
• B. Denial
• C. Bargaining
• D. Acceptance

Correct answer: C

Rationale: The client is in the bargaining stage of grief according to the Kubler-Ross model. In this stage, individuals negotiate for more time to achieve specific goals or fulfill desires. The client's statement about quitting smoking to attend their child's wedding reflects this bargaining behavior. Anger (choice A) is characterized by frustration and resentment, denial (choice B) involves avoidance of reality, and acceptance (choice D) signifies coming to terms with the situation, none of which align with the client's current mindset of bargaining.

2. While measuring a client’s oral temperature using an electronic thermometer, what action should the nurse take?

• A. Assist the client with oral hygiene before taking the temperature.
• B. Inquire whether the client has smoked in the last 30 minutes.
• C. Connect the red tip probe to the thermometer unit.
• D. Position the probe tip against the client’s buccal mucosa.

Correct answer: B

Rationale: The correct action for the nurse to take when measuring a client’s oral temperature using an electronic thermometer is to inquire whether the client has smoked in the last 30 minutes. Smoking can affect the accuracy of oral temperature readings. Providing oral hygiene (Choice A) is not directly related to ensuring accurate temperature measurement. Connecting the red tip probe (Choice C) is not specific to oral temperature measurement accuracy. Positioning the probe tip against the buccal mucosa (Choice D) is incorrect as oral temperature is typically measured under the tongue, not against the cheek.

3. A client is hospitalized for an infection of a surgical wound following abdominal surgery. To promote healing and fight wound infection, the nurse plans to arrange to increase the client's intake of:

• A. Vitamin C and Zinc
• B. Vitamin B12 and Calcium
• C. Vitamin D and Iron
• D. Vitamin A and Potassium

Correct answer: A

Rationale: The correct answer is A: Vitamin C and Zinc. Vitamin C is essential for collagen synthesis, which is important for wound healing. Zinc plays a crucial role in immune function and also aids in wound healing. Vitamin B12 and Calcium (Choice B) are not directly associated with wound healing properties. Vitamin D and Iron (Choice C) are important for overall health but are not specifically targeted for wound healing. Vitamin A and Potassium (Choice D) do not have direct wound healing properties and are not the best choices to promote wound healing and fight infection.

4. Which serum blood finding in diabetic ketoacidosis alerts the nurse that immediate action is required?

• A. pH below 7.3
• B. Potassium of 5.0
• C. HCT of 60
• D. PaO2 of 79%

Correct answer: C

Rationale: A hematocrit (HCT) of 60 indicates severe dehydration, a critical condition in diabetic ketoacidosis that requires immediate intervention. Severe dehydration can lead to hypovolemic shock and organ failure. While a low pH below 7.3 is indicative of acidosis, it may not require immediate action compared to severe dehydration. A potassium level of 5.0 is within the normal range and not a critical finding in this scenario. PaO2 of 79% reflects oxygenation status, which is important but not the most critical finding requiring immediate action in diabetic ketoacidosis.

5. Before starting an intensive exercise program, what instruction is most important for the nurse to provide to the client?

• A. Be sure to have a complete physical examination before beginning your planned exercise program.
• B. Be careful that the exercise program doesn't simply add to your stress level, making you want to eat more.
• C. Increased exercise helps to reduce stress, so you may not need to spend money on a stress management class.
• D. Make sure to monitor your weight loss regularly to provide a sense of accomplishment and motivation.

Correct answer: A

Rationale: Before starting an intensive exercise program, it is crucial for the client to have a complete physical examination. This examination ensures that the client is physically fit to engage in such activities and helps in identifying any underlying health issues that could be exacerbated by the exercise regimen. Choice B is incorrect because it focuses on stress levels related to eating habits rather than the importance of a physical examination for safety. Choice C is incorrect as exercise and stress management classes can complement each other rather than being mutually exclusive. Choice D is incorrect as monitoring weight loss, while important, is not as critical as ensuring the client's physical readiness for the exercise program.

Similar Questions