A nurse is admitting a client who is 1 week postpartum and reports excessive vaginal bleeding. The nurse speaks a different language than the client. The client's partner and 10-year-old child are accompanying her. Which of the following actions should the nurse take to gather the client's admission data?

Ask a nursing student who speaks the same language as the client to translate.

Allow the client's partner to translate.

Request a female interpreter through the facility.

Have the client's child translate.

Answer and Explanation

The Correct Answer is C

A. Ask a nursing student who speaks the same language as the client to translate: This is not appropriate, as the nursing student may not be trained in medical terminology or confidentiality, which could lead to miscommunication and potential breaches of privacy.

B. Allow the client's partner to translate: While the partner may understand the language, this approach can create conflicts of interest, and they may not be able to convey the full medical context or sensitive information accurately.

C. Request a female interpreter through the facility: This is the best action. Using a trained, professional interpreter ensures that the communication is accurate and confidential, allowing the nurse to gather necessary admission data effectively while respecting the client's comfort and cultural needs.

D. Have the client's child translate: It is not appropriate to involve a child in medical discussions, as they may not fully understand the context or terminology and could feel overwhelmed by the responsibility.

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Correct Answer is A

Explanation

A) “I will need to keep my hand elevated above my heart for several days.”: Elevating the hand above the heart helps reduce swelling and pain after surgery. This practice is crucial for promoting proper healing and minimizing discomfort.

B) “I should expect numbness and tingling in my hand.”: Numbness and tingling are not expected outcomes and could indicate complications. These symptoms should be reported to the healthcare provider for further evaluation.

C) “I should not use my affected hand for 4 to 6 weeks.”: Complete restriction of hand use for 4 to 6 weeks is unnecessary and could lead to stiffness and decreased function. Gradual use and movement are encouraged to aid recovery.

D) “I can apply heat for the first 24 hours to minimize the pain in my hand.”: Applying heat in the first 24 hours can increase swelling and should be avoided. Cold therapy is recommended initially to reduce inflammation and pain.

A. Playing with an imaginary friend B. Playing with a large plastic truck C. Playing with dress-up clothes D. Playing with a jump rope

Correct Answer is B

Explanation

A) Playing with an imaginary friend: While imaginative play does begin to develop in toddlers, having an imaginary friend is more typical in older preschool-aged children, around 3 to 4 years old. Therefore, this activity may not be expected in a 30-month-old child.

B) Playing with a large plastic truck: At 30 months old, children are typically engaged in parallel play and are interested in toys that promote gross motor skills and imaginative play. Playing with a large plastic truck is developmentally appropriate, as children at this age enjoy manipulating vehicles and may engage in simple pretend play related to driving or racing.

C) Playing with dress-up clothes: Although some children may enjoy dress-up, this activity tends to be more prominent in slightly older toddlers and preschoolers. A 30-month-old may show interest in dressing up but may not engage in it as frequently or with as much understanding of role play as older children.

D) Playing with a jump rope: Jump rope activities require a level of coordination and motor skills that are typically beyond what a 30-month-old child can achieve. At this age, children are still developing basic motor skills and would not yet be proficient in using a jump rope effectively.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who is postoperative following surgery for carpal tunnel syndrome. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

A nurse is caring for a 30-month-old child. Which of the following activities should the nurse expect the child to participate in?

Correct Answer is B

Explanation

A nurse is caring for a client who is experiencing status epilepticus. Which of the following medications should the nurse expect to administer?

A nurse is providing teaching to a client who is at 14 weeks of gestation about findings to report to the provider. Which of the following findings should the nurse include in the teaching?

A nurse is caring for a client who is in a coma and is scheduled for a surgical procedure. Which of the following actions should the nurse take?

A nurse is reviewing laboratory data from a client who has chronic kidney disease. Which of the following findings should the nurse expect?

A nurse is providing information for a client who has a new prescription for simvastatin. For which of the following should the nurse instruct the client to monitor and report to the provider?

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