A nurse is assessing a client who reports increased pain following physical therapy. Which of the following questions should the nurse ask when assessing the quality of the client's pain?

Correct Answer: D

Rationale: The correct answer is D: Is your pain sharp or dull? This question helps differentiate between different types of pain, which can provide valuable information about the underlying cause and guide appropriate interventions. Sharp pain is often associated with nerve or tissue damage, while dull pain may indicate inflammation or muscle strain. Asking about the quality of pain is crucial in pain assessment. A: Is your pain constant or intermittent? - This question focuses on the duration of pain rather than the quality. B: What would you rate your pain on a scale of 0 to 10? - This question assesses pain intensity, not quality. C: Does the pain radiate? - This question assesses pain distribution, not quality.

Correct Answer: C

Rationale: Rationale for Correct Answer C (require administration of insulin while taking prednisone): 1. Prednisone can increase blood glucose levels by reducing insulin sensitivity. 2. Metformin alone may not control blood glucose levels adequately in the presence of prednisone. 3. Therefore, the patient may require insulin to manage blood glucose levels while on prednisone. Summary of Incorrect Choices: A: This is incorrect because insulin administration is not necessary due to the rash or the interaction between metformin and prednisone. B: This is incorrect because prednisone can actually increase blood glucose levels, leading to hyperglycemia rather than hypoglycemia. D: This is incorrect because the rash is not likely caused by an interaction between metformin and prednisone, but rather an allergic reaction to an unknown cause.

Correct Answer: D

Rationale: The correct answer is D: Nursing excellence. The main focus of the Magnet Recognition Program is to recognize healthcare organizations that demonstrate nursing excellence in practice. This includes promoting a positive work environment, professional development, and quality patient care outcomes. Choice A, nurse satisfaction, is important but not the primary focus of the program. Choice B, patient outcomes, is related to nursing excellence but not the main focus of the program. Choice C, financial performance, is not directly related to nursing excellence and is not a focus of the Magnet Recognition Program.

Correct Answer: A

Rationale: Selye's stress theory, also known as the General Adaptation Syndrome, consists of 3 stages: alarm, resistance, and exhaustion. Long-term stress leads to exhaustion as the body's resources are depleted, making a person more susceptible to illnesses. Option A is correct as it aligns with this theory. Option B is incorrect as prolonged stress weakens the body, not makes it stronger. Option C is incorrect because stress does not necessarily lead to increased assertiveness. Option D is unrelated to Selye's stress theory.

Correct Answer: A

Rationale: The correct answer is A: The patient will reach a glycosylated hemoglobin level of less than 7%. This goal is most important because it directly addresses the patient's diabetes management by aiming to achieve good glycemic control. Lowering the HbA1c level to less than 7% is a key indicator of reduced risk for diabetes-related complications. Options B, C, and D are not as critical in addressing the specific nursing diagnosis of imbalanced nutrition. Option B focuses on weight loss, which may not necessarily address the underlying issue of imbalanced nutrition. Option C addresses meal distribution but does not directly target improved glycemic control. Option D emphasizes eliminating simple sugars but does not encompass the comprehensive management of diabetes.

Correct Answer: B

Rationale: The correct answer is B because amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, thus helping to prevent the transmission of pain impulses to the brain. This mechanism of action is effective in managing neuropathic pain, such as burning foot pain in diabetic patients. Choices A, C, and D are incorrect because amitriptyline's primary mechanism of action is related to its effects on neurotransmitter reuptake, not directly related to mood improvement, blood vessel changes, or sleep improvement.

Correct Answer: D

Rationale: The correct answer is D: Is your pain sharp or dull? This question helps differentiate between different types of pain, which can provide valuable information about the underlying cause and guide appropriate interventions. Sharp pain is often associated with nerve or tissue damage, while dull pain may indicate inflammation or muscle strain. Asking about the quality of pain is crucial in pain assessment. A: Is your pain constant or intermittent? - This question focuses on the duration of pain rather than the quality. B: What would you rate your pain on a scale of 0 to 10? - This question assesses pain intensity, not quality. C: Does the pain radiate? - This question assesses pain distribution, not quality.

Correct Answer: A

Rationale: The correct answer is A: Unfreeze the system. According to Lewin's Change Theory, the first step in the change process is to unfreeze the current state or system to prepare for change. This involves creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Moving the system to a new level (choice B) and refreezing the system (choice C) are subsequent steps in the change process after unfreezing. Evaluating the system (choice D) comes later in the process to assess the effectiveness of the change implemented. Therefore, unfreezing the system is the critical initial step to facilitate successful change implementation.

Correct Answer: C

Rationale: The correct answer is C because an elderly client awaiting a hip replacement typically requires ongoing support and coordination of services, making them a good candidate for case management. This client would benefit from assistance with navigating the healthcare system, coordinating appointments, and ensuring continuity of care post-surgery. Choice A is incorrect as the adolescent with a gunshot wound in the ER is likely to be in need of immediate medical intervention rather than case management. Choice B is incorrect as a young adult with a fractured pelvis may require medical treatment but may not necessarily need the level of ongoing support that case management provides. Choice D is incorrect as a 41-year-old client admitted for an outpatient tonsillectomy is a relatively straightforward procedure that may not require extensive case management services.