A nurse is assessing a client's coping skills. Which of the following should the nurse identify as an internal stressor?

Peer pressure.

Death of a family member.

Fear of medical test results.

Job transfer to another city.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Peer pressure (Choice A) is an external stressor, as it involves the influence of others on an individual's thoughts or actions. It originates from outside the individual and is not directly related to an internal psychological response.

Choice B rationale:

Death of a family member (Choice B) is an external stressor, as it is an event that occurs externally to the individual. While it can cause significant emotional distress, it is not considered an internal stressor.

Choice C rationale:

Fear of medical test results (Choice C) is the correct answer as an internal stressor. Internal stressors are psychological or emotional factors that originate within the individual and contribute to stress. Fear of medical test results is a personal worry that can lead to anxiety and emotional turmoil.

Choice D rationale:

Job transfer to another city (Choice D) is an external stressor, as it involves a change in the individual's external environment. It is not an internal psychological factor causing stress.

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Free Nursing Study Resources

Correct Answer is D

Explanation

The correct answer is choice d. When removing a peripheral IV catheter, the nurse uses scissors to remove the tape that secures the catheter.

Choice A rationale:

Inserting the tip of the enema tube 8 cm (3.1 in) is within the recommended range for adults, which is typically 7.5 to 10 cm (3 to 4 in). This action does not require intervention.

Choice B rationale:

Elevating the head of the bed when caring for a client’s body after death is a standard practice to prevent discoloration of the face and to facilitate drainage. This action does not require intervention.

Choice C rationale:

Using a clean washcloth, soap, and water for indwelling catheter care is appropriate and follows infection control guidelines. This action does not require intervention.

Choice D rationale:

Using scissors to remove the tape that secures a peripheral IV catheter is unsafe as it poses a risk of cutting the catheter or the client’s skin. This action requires intervention to ensure the nurse uses a safer method, such as using adhesive remover or gently peeling the tape away by hand.

Correct Answer is ["50"]

Explanation

Step 1: The total volume of the solution is 100 mL and it needs to be infused over 2 hours.

Step 2: To find the rate in mL/hr, divide the total volume by the total time.

Step 3: Calculation is (100 mL ÷ 2 hr).

Step 4: The IV pump should be set to deliver 50 mL/hr. This is the final answer, rounded to the nearest whole number as required.

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A nurse is assessing a client's coping skills. Which of the following should the nurse identify as an internal stressor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is observing a newly licensed nurse provide client care. Which of the following actions by the newly licensed nurse requires intervention by the nurse?

Correct Answer is D

Explanation

Correct Answer is ["50"]

Explanation

A nurse is teaching the family of a client who has a terminal illness about end-of-life care. Which of the following statements by a family member indicates an understanding of the teaching?

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