Nurses caring for a client with congestive heart failure. Which of the following prescriptions for the provider should the nurse anticipate?

Correct Answer: C

Rationale: Rationale: Choice C, giving the client enalapril 2.5 mg PO twice daily, is the correct answer as it is a common prescription for managing congestive heart failure by reducing workload on the heart. Enalapril is an ACE inhibitor that helps decrease blood pressure and improve heart function. It is crucial in managing symptoms and improving outcomes for clients with congestive heart failure. Choices A, B, and D are incorrect because they do not address the underlying issue of heart failure or follow evidence-based guidelines for treatment. Monitoring respiratory rate, giving IV bolus, or monitoring pulse rate are important but do not directly address the management of congestive heart failure as effectively as prescribing enalapril.

Correct Answer: D

Rationale: The correct answer is D: Axis IV. Axis IV in DSM-IV is used to assess psychosocial and environmental stressors impacting the individual. Mrs. Green's recent experiences of her dog's death and her mother's cancer diagnosis are significant stressors that would be categorized under Axis IV. These stressors can contribute to her current mental health condition and treatment plan. Choice A (Axis I) refers to clinical disorders, which are not directly related to external stressors. Choice B (Axis II) pertains to personality disorders, which are not the focus here. Choice C (Axis III) involves general medical conditions, which are not the primary concern in this scenario. Hence, the correct choice is D as it specifically addresses the psychosocial stressors impacting Mrs. Green's mental health.

Correct Answer: D

Rationale: The correct answer is D: select and participate in one group activity per day. This outcome directly addresses the nursing diagnosis of impaired social interaction and sociocultural dissonance by promoting engagement in social activities. By actively participating in a group activity, the patient can practice social skills and interact with others, thus improving social interaction. Choices A and B focus on individual skills rather than social interaction. Choice C relates to decision-making rather than social interaction. Therefore, choice D is the most appropriate outcome to address the patient's nursing diagnosis.

Correct Answer: B

Rationale: The correct answer is B because ensuring access to protective resources through social services is crucial in providing immediate support and safety for Harper. This initial goal focuses on addressing any immediate risks or needs related to her PTSD diagnosis. Play therapy (A) may be beneficial later but is not the primary concern at this stage. Teaching relaxation techniques (C) and understanding human response to trauma (D) are important but not as urgent as ensuring access to protective resources.

Correct Answer: C

Rationale: The correct answer is C: Has anyone told you about why you are here today? This question is the most appropriate as it helps establish the child's understanding of the situation and allows the nurse to assess the child's level of awareness and perception. By asking this question first, the nurse can ensure the child is informed and prepared for the counseling session. Choice A (How are you feeling?) is not the best first question as it jumps straight into emotions without setting the context. Choice B (How old are you?) is irrelevant and does not address the purpose of the counseling session. Choice D (Why do you think I'm talking to you alone without your parents here?) may make the child feel defensive or anxious, and it assumes the child has already formed opinions about the situation.

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: 1. Choice A emphasizes the nurse's regard for the client as a person of worth, emphasizing respect. 2. It highlights valuing and accepting the client without any conditions or reservations. 3. Demonstrates the core aspect of respect in communication, acknowledging the client's intrinsic value. 4. Reflects a fundamental principle of client-centered care, fostering a positive and supportive relationship. Summary of why other choices are incorrect: B. While understanding the client's perspective is important, it focuses more on empathy than respect. C. Self-congruence and authenticity are important but do not directly address respect for the client. D. Using specific terminology is valuable for clarity but does not directly relate to demonstrating respect for the client as a person of worth.

Correct Answer: B

Rationale: The correct answer is B: Domestic violence. In a situation where a woman arrives at an emergency homeless shelter with her children, domestic violence is the most likely reason for seeking shelter. Victims of domestic violence often flee their homes to escape abuse, seeking safety and shelter for themselves and their children. Substance abuse (A), unemployment (C), and imprisonment (D) are possible contributing factors to homelessness but are less likely to be the immediate reason for seeking emergency shelter in this scenario.

Correct Answer: D

Rationale: The correct answer is D: "Do you find it difficult to control your worrying?" This question is most appropriate because it directly assesses one of the key symptoms of generalized anxiety disorder, which is excessive and uncontrollable worrying. By asking this question, the nurse can gather crucial information to help confirm the diagnosis. A: "Have you been a victim of a crime or seen someone badly injured or killed?" - This question is more relevant to assessing symptoms of post-traumatic stress disorder rather than generalized anxiety disorder. B: "Do you feel especially uncomfortable in social situations involving people?" - This question is more indicative of social anxiety disorder rather than generalized anxiety disorder. C: "Do you repeatedly do certain things over and over again?" - This question is more aligned with symptoms of obsessive-compulsive disorder rather than generalized anxiety disorder.

Correct Answer: A

Rationale: The correct answer is A: Increase your salt intake if an activity causes you to perspire heavily. Lithium carbonate can cause dehydration and electrolyte imbalances through increased sweating. By increasing salt intake during activities that lead to heavy perspiration, the client can help maintain electrolyte balance. Choice B is incorrect because wearing sunscreen does not directly relate to lithium carbonate use. Choice C is incorrect as drinking less fluid can exacerbate dehydration risks associated with lithium carbonate. Choice D is incorrect as strenuous activities may increase sweating and electrolyte loss, necessitating adjustments such as increasing salt intake.