A nurse is discussing the five stages of grief by Kübler-Ross with a grief support group. Which of the following examples should the nurse identify as the first stage of the grief process?

A client refuses to discuss treatment options with her provider following a terminal diagnosis.

A client promises a higher power to live a better life if his cancer is healed.

A client withdraws from his social network following the death of a loved one.

A client yells at healthcare staff following the death of a loved one.

Answer and Explanation

The Correct Answer is A

A) A client refuses to discuss treatment options with her provider following a terminal diagnosis: This behavior exemplifies denial, the first stage in Kübler-Ross's five stages of grief. In this stage, individuals are unable to accept the reality of their situation, often refusing to acknowledge the facts and avoiding discussions that might confirm the severity of their condition.

B) A client promises a higher power to live a better life if his cancer is healed: This illustrates the bargaining stage, where individuals attempt to negotiate or make deals with a higher power or fate to reverse or delay the loss or illness. They hope that by promising to change their behavior, they can influence the outcome.

C) A client withdraws from his social network following the death of a loved one: Withdrawal from social interactions is indicative of the depression stage, where individuals may feel profound sadness, hopelessness, and a desire to isolate themselves as they process the magnitude of their loss.

D) A client yells at healthcare staff following the death of a loved one: This behavior is characteristic of the anger stage, where individuals express their frustration and helplessness through anger, often directed at people around them, including healthcare providers. This stage reflects the struggle to find meaning and control in the face of loss.

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Correct Answer is ["B","C","E"]

Explanation

A) Urticaria:
Urticaria, or hives, is a skin reaction characterized by itchy, raised welts. It is not typically associated with a small bowel obstruction, which primarily affects the gastrointestinal system rather than the skin.

B) Vomiting:
Vomiting is a common symptom of a complete small bowel obstruction. It occurs due to the blockage in the intestines, which prevents the passage of contents, leading to nausea and vomiting as the body tries to expel the obstruction.

C) Distended abdomen:
A distended abdomen is expected in cases of small bowel obstruction. The blockage causes a buildup of gas and fluids, leading to abdominal swelling and distention as the normal passage of intestinal contents is impeded.

D) Fluid overload:
Fluid overload is not a typical manifestation of a small bowel obstruction. Instead, dehydration and electrolyte imbalances are more likely due to vomiting and the inability to absorb fluids and nutrients properly.

E) Obstipation:
Obstipation, or severe constipation with an inability to pass stool or gas, is a key sign of a complete small bowel obstruction. The obstruction prevents the normal movement of intestinal contents, leading to a cessation of bowel movements.

A. Decreased magnesium level B. Decreased total calcium level C. Elevated phosphate level D. Elevated sodium level

Correct Answer is D

Explanation

A) Decreased magnesium level: Primary aldosteronism typically affects sodium and potassium balance, but it is less likely to cause significant changes in magnesium levels. Therefore, a decreased magnesium level is not the expected electrolyte imbalance in this condition.

B) Decreased total calcium level: Primary aldosteronism does not primarily affect calcium metabolism. While calcium levels could be influenced indirectly, they are not a primary concern in this disorder. Hence, a decreased total calcium level is not expected.

C) Elevated phosphate level: Phosphate levels are generally not directly influenced by aldosterone. Elevated phosphate levels might be seen in other conditions, but they are not characteristic of primary aldosteronism.

D) Elevated sodium level: Primary aldosteronism leads to excess production of aldosterone, which promotes sodium retention by the kidneys. This retention causes elevated sodium levels, resulting in hypernatremia, and contributes to symptoms like frequent urination due to the body's attempt to excrete excess sodium through increased urine production.

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A nurse is discussing the five stages of grief by Kübler-Ross with a grief support group. Which of the following examples should the nurse identify as the first stage of the grief process?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has a complete small bowel obstruction. Which of the following manifestations should the nurse expect? (Select all that apply.)

Correct Answer is ["B","C","E"]

Explanation

A nurse is reviewing the laboratory report of an older adult client who has primary aldosteronism and reports needing to urinate three to four times during the night. Which of the following electrolyte imbalances should the nurse expect?

Correct Answer is D

Explanation

A nurse is planning discharge teaching for an adolescent who has a new diagnosis of type 1 diabetes mellitus. Which of the following information should the nurse include in the plan?

A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?

A nurse is providing discharge planning for a young adult client who is postoperative following a myringotomy. Which of the following information should the nurse include in the discharge planning?

A nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take?

A nurse is providing discharge teaching to a client who has a hearing impairment and a new hearing aid. Which of the following client statements indicates an understanding of the teaching?

A nurse is teaching a client who has generalized anxiety disorder and a new prescription of buspirone. The nurse should instruct the client to notify the provider of which of the following findings as an adverse effect of buspirone?

A nurse is planning care for a client who has pyelonephritis. Which of the following interventions should the nurse include in the plan?

A nurse is providing teaching to a client who has the communicable disease tuberculosis. Which of the following statements by the client indicates an understanding of the teaching?