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Questions 149

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Question 1 of 5

Three days after admission for treatment of Valium addiction, a young woman briefly left the hospital to talk to a visitor. Her psychiatrist has threatened to discharge her for noncompliance with the treatment program. The client seems very despondent, refusing to get out of bed. The evening nurse finds the client crying, 'I've screwed everything up. It's hopeless. It's no use.' In responding to the client, which of the following would be most appropriate?

Correct Answer: D

Rationale: Acknowledging her sadness and assessing for suicidal ideation addresses her emotional state and ensures safety, given her despondency.

Question 2 of 5

The nurse is caring for the 5-year-old with rubeola. Which intervention by the nurse best ensures the child's comfort?

Correct Answer: A

Rationale: Rubeola (measles) causes photophobia; dimming lights reduces discomfort. Baby oil baths, warm mist tents, and decongestants do not address primary symptoms.

Question 3 of 5

The nurse is preparing to review the HCP's written instructions with the parent of the pediatric client who has diarrhea caused by Escherichia coli (E. coli). Which instruction should the nurse question?

Correct Answer: B

Rationale: Encouraging any beverage may include inappropriate choices (e.g., sugary drinks) that worsen diarrhea; rehydration solutions are preferred.

Question 4 of 5

An elderly woman is admitted to the hospital with a productive cough, progressive forgetfulness, an inability to concentrate, and disinterest in her personal hygiene. What should be of greatest priority as the nurse assesses this client?

Correct Answer: D

Rationale: A productive cough is a priority as it may indicate a respiratory infection, which can be life-threatening in the elderly, requiring immediate assessment.

Question 5 of 5

The client asks the nurse how a woman can recognize when she is ovulating. Which should be the nurse's response?

Correct Answer: A

Rationale: A. At the time of ovulation, the mucus produced by the cervix becomes more abundant and stretchy. It looks and feels like egg whites. The ability of the mucus to be stretched indicates the time of maximum fertility. B. At the time of ovulation, the basal body temperature drops slightly and then, under the influence of progesterone, increases and stays elevated until 2 to 4 days before menstruation starts. C. Home measurement of luteinizing hormone (LH) is possible with dipstick urine tests. A positive test (not negative) for LH indicates ovulation. LH causes the egg to be released from the ovary. D. At the time of ovulation, most females note an increase (not decrease) in libido.

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