While completing an admission database, the nurse is interviewing a patient who states “I am allergic to latex.” Which action will the nurse take first?

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Pharmacology and the Nursing Process 10th Edition Test Bank Questions

Question 1 of 5

While completing an admission database, the nurse is interviewing a patient who states “I am allergic to latex.” Which action will the nurse take first?

Correct Answer: B

Rationale: The correct answer is B: Ask the patient to describe the type of reaction. First, the nurse needs to assess the severity of the latex allergy to determine the appropriate interventions. Understanding the type of reaction can help guide treatment and prevent future exposure. Isolating the patient (choice A) is not necessary unless there is a severe reaction. Terminating the interview (choice C) prematurely is not appropriate as crucial information may be missed. Documenting the allergy (choice D) is important but not as urgent as assessing the reaction type.

Question 2 of 5

A nurse is completing a care plan. Which intervention is most appropriate for the nursing diagnostic statement Impaired skin integrity related to shearing forces?

Correct Answer: B

Rationale: The correct answer is B because turning the patient every 2 hours helps prevent pressure ulcers caused by shearing forces. This intervention redistributes pressure, improving blood flow to the skin, thus reducing the risk of skin breakdown. Administering pain medication (A) does not directly address the skin integrity issue. Monitoring vital signs (C) is important but does not address skin integrity. Keeping bed rails up (D) may actually increase the risk of shearing forces.

Question 3 of 5

The nurse establishes trust and talks with a school-aged patient before administering an injection. Which type of implementation skill is the nurse using?

Correct Answer: B

Rationale: The correct answer is B: Interpersonal. The nurse is using interpersonal skills by establishing trust and communicating with the patient before administering the injection. This helps build rapport and alleviate anxiety. Cognitive skills involve problem-solving and critical thinking, not direct patient interaction. Psychomotor skills relate to physical tasks like giving injections. Judgmental skills involve making decisions based on critical thinking, not directly related to patient communication.

Question 4 of 5

A goal for a patient with diabetes is to demonstrate effective coping skills. Which patient behavior will indicate to the nurse achievement of this outcome?

Correct Answer: A

Rationale: The correct answer is A because stating feeling better after talking with family and friends demonstrates the use of healthy coping skills. This behavior indicates the patient is seeking and utilizing social support, which is crucial for managing stress and emotions effectively in diabetes management. Choices B, C, and D are incorrect because consuming high-carbohydrate foods when stressed can lead to poor blood sugar control, disliking support group meetings indicates avoidance of beneficial support resources, and spending most of the day in bed can contribute to physical and emotional deterioration, rather than effective coping.

Question 5 of 5

A nurse is collecting information from a client with dementia. The client’s daughter accompanies the client. Which of the following statements by the nurse would recognize the client’s value as an individual?

Correct Answer: C

Rationale: The correct answer is C because it acknowledges the client's value as an individual by directly addressing them and asking about their own self-care practices, which respects their autonomy and personhood. Choice A focuses on the client's father rather than the client themselves. Choice B addresses the daughter, not the client, and implies a lack of prioritization of the client's needs. Choice D is dismissive and does not recognize the client's capacity to communicate, undermining their dignity.

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