When the nurse enters the room to change the dressing of a male client with cancer, he asks, 'Have you ever been with someone when they died?' What is the nurse's best response to him?

Correct Answer: A

Rationale: The correct answer is A because it demonstrates empathy and encourages open communication. By acknowledging the client's question and offering to address any concerns, the nurse shows understanding and willingness to support the client emotionally. This response also promotes a therapeutic relationship and allows the client to express his feelings and fears. Choices B, C, and D are incorrect because they do not address the client's emotional needs or provide an opportunity for him to discuss his concerns about death. B and C are dismissive and do not encourage further discussion, while D minimizes the client's feelings and redirects the conversation away from his concerns.

Correct Answer: A

Rationale: The correct answer is A - Blow cool air from a hair dryer under the cast. This method helps relieve itching without causing harm or compromising the cast. It allows for ventilation and cooling without introducing foreign objects that may cause skin irritation or damage. The other choices are incorrect because twisting the cast, shaking powder into it, or pushing a pencil under the cast can all potentially damage the cast or harm the child's skin. It is important to follow appropriate and safe methods to address itching while the cast is in place.

Correct Answer: B

Rationale: The correct answer is B: Inspection of the mouth. Phenytoin can cause gingival hyperplasia as a common untoward effect. The nurse should monitor the client's oral cavity regularly for signs of gum overgrowth. Bladder palpation (A) is not relevant to phenytoin side effects. Blood glucose monitoring (C) is typically not associated with phenytoin use. Auscultation of breath sounds (D) is not a specific assessment for phenytoin side effects.

Correct Answer: C

Rationale: The correct answer is C: Select a large, deep muscle mass. This is important because using a large, deep muscle mass helps distribute the medication effectively and reduces the risk of tissue irritation and nerve damage. It also allows for better absorption of the medication. Option A is incorrect because instilling the medication quickly can cause pain and tissue damage. Option B is incorrect as inserting the needle slowly does not necessarily impact the effectiveness of the injection. Option D is incorrect as using a short, small gauge needle may not reach the desired muscle depth for optimal medication absorption. Therefore, selecting a large, deep muscle mass is the best intervention for administering an intramuscular injection containing a painful medication.

Correct Answer: A

Rationale: The correct answer is A because a patient whose discharge has been delayed due to a postoperative infection can benefit from the skills of a newly graduated practical nurse without requiring constant supervision. This patient likely needs routine wound care, medication administration, and monitoring, tasks that align with the competencies of a practical nurse. Assigning this patient allows the new nurse to practice skills independently while still providing valuable care. Choices B, C, and D are incorrect because they involve patients with complex needs that require a higher level of expertise and supervision. Patients with poorly controlled diabetes on insulin, head injury requiring frequent assessments, and IV heparin administration need closer monitoring and specialized care that may exceed the scope of practice for a new graduate without adequate supervision. Assigning these patients to the new nurse could compromise patient safety and quality of care.