A nurse is discussing the components of the working phase of the nurse-client relationship with a client. Which of the following tasks are specific for this stage to create a therapeutic environment?

Reviewing client education

identifying problem-solving skills

Summarizing the goals and objectives achieved

Specifying a contract

Answer and Explanation

The Correct Answer is B

A. Reviewing client education: Reviewing education is often part of the termination phase, where teaching is reinforced and the nurse ensures the client understands care plans after the therapeutic relationship ends. It is not a primary focus during the working phase.

B. Identifying problem-solving skills: The working phase focuses on active problem-solving, setting goals, and implementing strategies to address the client's issues. This is when trust is established further, and the nurse and client collaborate on interventions and coping techniques to promote positive outcomes.

C. Summarizing the goals and objectives achieved: Summarizing achievements is part of the termination phase, when the nurse and client reflect on progress made. It helps bring closure to the relationship but does not belong to the working phase where the focus is still on active progress.

D. Specifying a contract: Specifying a contract is a task of the orientation phase, where the structure of the nurse-client relationship, roles, and expectations are defined. This lays the foundation before entering into the problem-solving focus of the working phase.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Pneumonia: The preschooler is showing signs of shallow breathing, refusal to use the incentive spirometer, and slightly diminished breath sounds in the bilateral lower lobes, all of which increase the risk of developing pneumonia. Postoperative patients, especially young children, are vulnerable to pneumonia due to pain-limited deep breathing and poor pulmonary expansion.
Wound infection: Although there is some serosanguinous drainage at the incision site, the dressing remains dry overall, and there is no mention of redness, warmth, or purulent discharge typically associated with wound infection. Therefore, wound infection is not the primary concern at this point.
Ileus: Hypoactive bowel sounds are present, but they have been stable throughout the day without worsening abdominal distension or absence of bowel function. While ileus is a postoperative risk, the more pressing concern given the respiratory findings is pneumonia.
Shallow breathing: The child consistently shows shallow, unlabored respirations throughout assessments, which indicate limited lung expansion. Without effective use of the incentive spirometer and adequate deep breathing, shallow breathing places the child at high risk for pulmonary complications such as pneumonia.
Increasing temperature: Although the child's temperature rose slightly by 1600, it remains below 38° C (100.4° F), which is not typically classified as a fever. The minor temperature elevation could be related to inflammation rather than an infectious process at this stage.
Hypoactive bowel sounds: Hypoactive bowel sounds are expected in the early postoperative period, particularly following abdominal surgery due to the effects of anesthesia and manipulation of the bowel during surgery. While they should be monitored, they are not the primary finding indicating the most urgent complication in this situation.

A. Administer the tablet to the client with applesauce. B. Position the client at a 45 angle C. Crush the tablet and mix it in pudding for the client. D. Instruct the client to tilt their head back when swallowing

Correct Answer is A

Explanation

A. Administer the tablet to the client with applesauce: Administering the tablet with a small amount of soft food like applesauce can help facilitate swallowing without altering the integrity of the enteric coating. This method eases the swallowing process while ensuring the medication is delivered properly.

B. Position the client at a 45-degree angle: Clients who have difficulty swallowing should be positioned in an upright 90-degree sitting position, not at 45 degrees, to reduce the risk of aspiration and promote safer swallowing mechanics.

C. Crush the tablet and mix it in pudding for the client: Enteric-coated tablets should never be crushed, as crushing destroys the protective coating designed to prevent the medication from being released in the stomach, potentially causing irritation or reducing drug effectiveness.

D. Instruct the client to tilt their head back when swallowing: Tilting the head back increases the risk of choking and aspiration, especially in clients with swallowing difficulties. It is safer to encourage tucking the chin slightly down when swallowing to help protect the airway.

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Area assessed	Findings
Neurological	Drowsy but easy to arouse
Vital Signs	Temperature 35.3°C (95.5° F) Heart rate 60/min Respiratory rate 16/min Blood pressure 90/60 mm Hg Oxygen saturation 94% (oxygen at 2 L/min via nasal cannula) Rates pain as 1 on 0/10 pain scale.
Integumentary	Skin cool and moist to touch.
Cardiopulmonary	Heart rate regular. Pedal pulse +1 bilateral. Lungs clear bilateral. Respirations even, nonlabored.
Abdomen	Abdomen soft, nondistended. Bowel sounds hypoactive in all four quadrants. 2x2 gauze with a clear transparent dressing intact to right lower and upper abdominal quadrant. Moderate amount of sanguineous drainage noted on the lower dressing

A nurse is discussing the components of the working phase of the nurse-client relationship with a client. Which of the following tasks are specific for this stage to create a therapeutic environment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a preschooler who is postoperative following an appendectomy. Complete the following sentence by using the lists of options. The pre-schooler is at risk for developing ______ evidenced by the pre-schooler's _________

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

A nurse is administering an enteric-coated medication to an adult client who has right-sided weakness and is having difficulty swallowing tablet. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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A nurse is performing blood glucose monitoring on a client. Which of the following actions should the nurse take?

A nurse is documenting client care in the nurses' notes and notices that a space was left blank. Which of the following actions should the nurse take?

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