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 C

Explanation

A) Cimetidine: Cimetidine is an H2 receptor antagonist used to reduce stomach acid and treat conditions such as peptic ulcers and gastroesophageal reflux disease (GERD). It is not used to manage metabolic acidosis.

B) Calcitonin: Calcitonin is used to regulate calcium levels and treat conditions like osteoporosis or hypercalcemia. It does not address metabolic acidosis and is not appropriate for this condition.

C) Sodium bicarbonate: Sodium bicarbonate is commonly used to treat metabolic acidosis. It works by neutralizing excess acid in the blood, thereby increasing the blood's pH and helping to correct the acid-base imbalance associated with metabolic acidosis.

D) Sodium chloride: Sodium chloride is a salt that can be used to manage fluid and electrolyte imbalances but does not correct metabolic acidosis. It is not suitable for treating the acid-base imbalance seen in metabolic acidosis.

A. Teach the client to void over a urine strainer. B. Administer oxybutynin to the client twice per day. C. Encourage frequent ambulation for the client. D. Check the client's urine for ketones three times per day. E. Instruct the client to drink 3 L of fluid per day.

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

Explanation

A) Teach the client to void over a urine strainer: After lithotripsy, clients are often advised to void over a strainer to catch any small stone fragments that may pass. This helps in monitoring the passage of stone fragments and ensures that any remaining stones can be analyzed for further management.

B) Administer oxybutynin to the client twice per day: Oxybutynin is an anticholinergic medication used to treat bladder spasms. It is not routinely used after lithotripsy unless specifically prescribed for bladder spasms, which are not a common postoperative concern for this procedure.

C) Encourage frequent ambulation for the client: Frequent ambulation is beneficial after lithotripsy as it helps promote overall recovery, reduces the risk of complications like deep vein thrombosis, and can facilitate the passage of stone fragments. Encouraging movement is an essential aspect of postoperative care.

D) Check the client's urine for ketones three times per day: Monitoring for ketones is not typically required following lithotripsy unless there is a specific concern about diabetic ketoacidosis or another condition that warrants ketone monitoring. It is not a standard intervention for postoperative care after lithotripsy.

E) Instruct the client to drink 3 L of fluid per day: Increasing fluid intake is crucial after lithotripsy to help flush out any remaining stone fragments and to prevent new stone formation. Drinking 3 liters of fluid per day is generally recommended to maintain adequate hydration and support the urinary system.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has chronic glomerulonephritis and has developed metabolic acidosis. Which of the following medications should the nurse expect to administer?

Correct Answer is C

Explanation

A nurse is planning care for a client who is postoperative following a lithotripsy for renal calculi. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

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

Explanation

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