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NEW QUESTION 39
As a nurse works with an adolescent with cystic fibrosis, the nurse begins to notice that he appears depressed and talks about suicide and feelings of worthlessness. This is an important factor to consider in planning for his care because:

• A. He needs to be confronted with his feelings and forced to work through them
• B. It may be a bid for attention and an indication that more diversionary activity should be planned for him
• C. No threat of suicide should be ignored or challenged in any way
• D. He needs to be observed carefully for signs that his depression has been relieved

Answer: C

Explanation:
Explanation
(A) Threats of suicide should always be taken seriously. (B) This client has a life-threatening chronic illness.
He may be concerned about dying or he may actually be contemplating suicide. (C) Sometimes clients who have made the decision to commit suicide appear to be less depressed. (D) Forcing him to look at his feelings may cause him to build a defense against the depression with behavioral or psychosomatic disturbances.

NEW QUESTION 40
A client has been taking lithium 300 mg po bid for the past two weeks. This morning her lithium level was 1 mEq/L. The nurse should:

• A. Notify the physician immediately
• B. Administer the morning lithium dose as scheduled
• C. Hold the morning lithium dose and continue to observe the client
• D. Obtain an order for benztropine (Cogentin)

Answer: B

Explanation:
Section: Questions Set G
Explanation:
(A) There is no need to phone the physician because the lithium level is within therapeutic range and because there are no indications of toxicity present. (B) There is no reason to withhold the lithium because the blood level is within therapeutic range. Also, it is necessary to give the medication as scheduled to maintain adequate blood levels. (C) The lab results indicate that the client's lithium level is within therapeutic range (0.2-1.4 mEq/ L), so the medication should be given as ordered. (D) Benztropine is an antiparkinsonism drug frequently given to counteract extrapyramidal symptoms associated with the administration of antipsychotic drugs (not lithium).

NEW QUESTION 41
A 48-year-old client is being seen in her physician's office for complaints of indigestion, heartburn, right upper quadrant pain, and nausea of 4 days' duration, especially after meals. The nurse realizes that these symptoms may be associated with cholecystitis and therefore would check for which specific sign during the abdominal assessment?

• A. Cullen's sign
• B. Murphy's sign
• C. Rebound tenderness
• D. Turner's sign

Answer: B

Explanation:
(A) This sign is a faint blue discoloration around the umbilicus found in clients who have hemorrhagic pancreatitis. (B) This sign indicates areas of inflammation within the peritoneum, such as with appendicitis. It is a deep palpation technique used on a nontender area of the abdomen, and when the palpating hand is removed suddenly, the client experiences a sharp, stabbing pain at an area of peritoneal inflammation. (C) This sign is considered positive with acute cholecystitis when the client is unable to take a deep breath while the right upper quadrant is being deeply palpated. The client will elicit a sudden, sharp gasp, which means the gallbladder is acutely inflamed. (D) This is a sign of acute hemorrhagic pancreatitis and manifests as a green or purple discoloration in the flanks.

NEW QUESTION 42
An 80-year-old male client with a history of arteriosclerosis is experiencing severe pain in his left leg that started approximately 20 minutes ago. When performing the admission assessment, the nurse would expect to observe which of the following:

• A. Decreased or absent pedal pulse in the left leg
• B. Both lower extremities warm to touch with 2_pedal pulses
• C. The left leg warmer to touch than the right leg
• D. Both lower extremities cyanotic when placed in a dependent position

Answer: A

Explanation:
Explanation
(A) This statement describes a normal assessment finding of the lower extremities. (B) This assessment finding reflects problems caused by venous insufficiency. (C) Decreased or absentpedal pulses reflect a problem caused by arterial insufficiency. (D) The leg that is experiencing arterial insufficiency would be cool to touch due to the decreased circulation.

NEW QUESTION 43
When planning care for a 9-year-old client, the nurse uses which of the most effective means of helping siblings cope with their feelings about a brother who is terminally ill?

• A. Storytelling
• B. Play-acting out feelings in different roles
• C. Open discussion and understanding
• D. Drawing pictures

Answer: B

Explanation:
Explanation/Reference:
Explanation:
(A) When dealing with grief, siblings are usually most comfortable initially with open discussion. (B) Assuming different roles allows children to act out their feelings without fear of reprisals and to gain insight and control. (C) This method may be helpful, but having the child take an active part through role playing is more effective. (D) This technique may be helpful, but being an active participant through role playing is more effective.

NEW QUESTION 44
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