A client is discharged to home following hospitalization for percutaneous endoscopic gastrostomy tube placement to assist with nutrition. The client's primary diagnosis is amyotrophic lateral sclerosis (ALS). The client can transfer from the bed to a chair but can't walk.

The client and their family are concerned about the client's ability to maintain mobility at the highest possible level following a surgical procedure. The nursing diagnosis most appropriate for this client is ...

Impaired physical mobility related to decreased motor agility secondary to ALS as manifested by inability to ambulate.

Hopelessness related to impaired ability to cope.

Caregiver role strain related to care recipient's unrealistic expectations of caregiver.

Impaired memory related to reduced quality and quantity of information processed.

Answer and Explanation

The Correct Answer is A

Choice A rationale: In ALS, impaired physical mobility due to decreased motor agility and the inability to ambulate is a direct consequence of the disease.

Choice B rationale: Hopelessness might be a possible emotional response but doesn't address the client's physical limitations due to ALS.

Choice C rationale: Caregiver role strain is related to the family's ability to manage caregiving responsibilities and is not the primary concern for the client's physical mobility.

Choice D rationale: Impaired memory is not the primary issue in ALS; the client's inability to ambulate due to decreased motor function is the main focus for this nursing diagnosis.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale: The patient with type 2 diabetes admitted with pneumonia might not necessarily need insulin therapy to prevent ketoacidosis.

Choice B rationale: Type 2 diabetes doesn't typically involve islet cell antibodies destroying the pancreas's ability to produce insulin.

Choice C rationale: In this scenario, the patient might have enough endogenous insulin to prevent ketosis but could be at risk for hyperosmolar hyperglycemic syndrome due to illness-induced stress.

Choice D rationale: Type 2 diabetes often involves some degree of endogenous insulin secretion, and not all patients require daily insulin injections.

A. Client with a worse joint deformity since the last visit B. Client with a red, hot, swollen right wrist C. Client who has a puffy-looking area behind the knee D. Client who reports jaw pain when eating

Correct Answer is B

Explanation

Choice A rationale: While joint deformities are concerning in RA, the immediate attention would be required for an acute, red, hot, swollen joint which could indicate an active inflammatory process.
Choice B rationale: Redness, heat, and swelling in a joint are signs of an acute flare in rheumatoid arthritis and might require urgent intervention to manage the inflammation.
Choice C rationale: Puffy-looking areas behind the knee might indicate joint involvement but might not require immediate attention as much as an acutely inflamed joint.
Choice D rationale: Jaw pain while eating can be a symptom of TMJ involvement in RA, but an acutely inflamed joint would generally take precedence.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement would be correct for a patient with type 2 diabetes who was admitted to the hospital with pneumonia?

Correct Answer is C

Explanation

A nurse assesses a group of clients who have rheumatoid arthritis (RA). Which client would the nurse see first?

Correct Answer is B

Explanation

The nurse is caring for a client who presents with acute appendicitis: Exhibits Select all that apply?

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

A patient with gonorrhea is treated with a single IM dose of ceftriaxone and is given a prescription for azithromycin (Zithromax) 1000 mg 1 dose. What rationale should the nurse provide to the patient for this combination?

The nurse observes the final diagnosis of four clients in their case reports as given below. In which client does the nurse notice the presence of Chvostek sign and Trousseau sign?

Which of the following imagine the nurse will recognize as a positive evidence of adenomyosis?

What topic should the nurse plan as a priority to teach a 26-year-old patient who has been treated for pelvic inflammatory disease?

After a breast examination, the nurse is documenting assessment findings that indicate possible breast cancer. Which abnormal findings need to be included as part of the client's electronic medical record? (Select all that apply.)