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Question 1 of 5

A 45-year-old male client was admitted to a chemical dependency treatment center following legal problems related to alcohol abuse. He states, 'I know that alcohol is a problem for some people, but I can stop whenever I want to. I'm never sick or miss work, and no one can complain about me.' During the initial assessment, the best response by the nurse would be:

Correct Answer: B

Rationale: Direct confrontation initially is nontherapeutic and may result in the client becoming frustrated and wanting to leave. A positive, supportive attitude builds trust, and identifying positive strength raises self-esteem. Offering help allows the client to feel that he is not alone in dealing with problems. Asking the client why or to give an explanation for his behavior puts him in a position of having to justify his behavior to the nurse. Giving approval or placing a value on feelings or a behavior may limit the client's freedom to behave in a way that may displease another. This response may lead to seeking praise instead of progress.

Question 2 of 5

A female client is admitted to the emergency department complaining of severe right-sided abdominal pain and vaginal spotting. She states that her last menstrual period was about 2 months ago. A positive pregnancy test result and ultrasonography confirm an ectopic pregnancy. The nurse could best explain to the client that her condition is caused by:

Correct Answer: B

Rationale: The embryo itself may develop normally in the first several weeks of an ectopic pregnancy. An ectopic pregnancy in the fallopian tube causes severe pain owing to the size of the growing embryo within the narrow lumen of the tube, causing distention and finally rupture within the first 12 weeks of pregnancy. The Fallopian tube may either be normal or contain adhesions caused by a history of pelvic inflammatory disease or tubal surgeries, neither of which are congenital causes. An ectopic pregnancy does not involve a dysfunctional placenta, but the implantation of the blastocyst outside the uterus.

Question 3 of 5

A client hospitalized with cirrhosis has developed abdominal ascites. The nurse should provide the client with snacks that provide additional:

Correct Answer: C

Rationale: Ascites in cirrhosis is linked to hypoalbuminemia; increasing protein intake helps restore albumin levels, reducing fluid accumulation.

Question 4 of 5

The nurse is caring for a client with a history of a pulmonary embolism who is receiving Lovenox (enoxaparin). The nurse should monitor the client for:

Correct Answer: A

Rationale: Enoxaparin, a low-molecular-weight heparin, increases bleeding risk, requiring monitoring for signs like bruising or hematuria. Hypertension, tachypnea, and fever are not primary concerns.

Question 5 of 5

A client with a history of osteoarthritis is admitted with complaints of joint stiffness. The nurse should expect the client to have:

Correct Answer: A

Rationale: Osteoarthritis causes joint pain worsened by activity due to cartilage degeneration, unlike rheumatoid arthritis, which involves prolonged morning stiffness.

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