Question

A nurse is assisting with the care of a client who has had a prostatectomy.

Answer 1

Correct Answers:

Assist the client with a sitz bath.
Encourage oral fluid intake.

Rationale :

Assist the client with a sitz bath

🌻 A sitz bath is appropriate after a prostatectomy because warm water immersion helps promote perineal comfort, cleanliness, and healing after surgery.

🌻 The client has a perineal dressing with minimal serosanguinous drainage, which is an expected finding during the postoperative period.

🌻 A sitz bath can reduce perineal discomfort and muscle tension while supporting hygiene around the surgical area.

🌻 This intervention is especially helpful after procedures involving the prostate because the perineal region may experience swelling and soreness.

🌻 The nurse should ensure the incision area is monitored for signs of infection, increased bleeding, or abnormal drainage.

🌻 Providing comfort measures helps improve recovery while avoiding unnecessary manipulation of the surgical site.

🌻Assisting with a sitz bath is a safe and beneficial postoperative intervention.

Encourage oral fluid intake

🌻 Encouraging oral fluid intake is appropriate because hydration helps maintain urinary flow and catheter patency after prostatectomy.

🌻 The client has an indwelling urinary catheter with 100 mL/hr of pink urine, which is an expected postoperative finding due to mild bleeding from the surgical area.

🌻 Adequate fluid intake helps prevent the formation of blood clots in the bladder that could obstruct catheter drainage.

🌻 Increased fluids also promote bladder irrigation naturally by maintaining continuous urine production.

🌻 The nurse should continue monitoring urine color, amount, and catheter function.

🌻 Fluid intake supports recovery and reduces the risk of urinary complications after prostate surgery.

🌻 Encouraging fluids is an appropriate nursing action for this client.

Distractor Analysis :

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Answer 2

Correct Answers:

Encourage the client to be assertive.

Rationale :

🌼 Encouraging assertiveness is appropriate for a client with dependent personality disorder because the primary goal of treatment is to promote independence, confidence, and decision-making skills.

🌼 Clients with dependent personality disorder often have an excessive need to be taken care of, difficulty making decisions independently, and fear of separation or rejection.

🌼 Teaching the client to express opinions, needs, and preferences helps build self-esteem and reduces reliance on others.

🌼 The caregiver should provide support while allowing the client opportunities to make choices and develop problem-solving abilities.

🌼 Encouraging independence helps prevent reinforcement of dependent behaviors that maintain the disorder.

🌼 The nurse should promote a therapeutic environment that balances assistance with opportunities for self-management.

🌼 Developing assertiveness is an important step toward improving functioning and autonomy.

Distractor Analysis :

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Answer 3

Correct Answers

Blank 1 Correct Option: Anorexia nervosa.
Blank 2 Correct Option: Provide a structured meal environment.
Blank 3 Correct Option: Focus on the client's underlying feelings of dysphoria.
Blank 4 Correct Option: Cardiac function with ECG.
Blank 5 Correct Option: Weight on a daily basis.

Rationale :

Potential Condition:

✅ Anorexia nervosa

🌻 The client is experiencing anorexia nervosa because the findings show severe restriction of food intake, intense fear of weight gain, distorted body image, and significantly low body weight.

🌻 The client has a BMI of 15, which indicates severe underweight status, and reports avoiding carbohydrates and sugar because they “felt fat.”

🌻 Physical findings including lanugo, dry skin, thin hair, amenorrhea, hypotension, sinus bradycardia, and electrolyte abnormalities are classic complications of anorexia nervosa.

🌻 The client’s behavior of throwing food away and restricting intake supports an eating disorder characterized by intentional caloric restriction.

🌻 The client’s vomiting episode occurred after being forced to eat, but the main pattern is restriction rather than recurrent binge-purge behavior.

🌻 Treatment focuses on nutritional rehabilitation, structured meals, and addressing distorted thoughts about body image and food.

Actions to Take

✅ Provide a structured meal environment

🌻 A structured meal environment is appropriate because clients with anorexia nervosa often have severe anxiety around eating and may engage in behaviors to avoid food intake.

🌻 Supervised meals help ensure the client consumes adequate nutrition and prevent behaviors such as discarding food or hiding meals.

🌻 Consistent meal routines reduce anxiety and provide a predictable therapeutic setting.

🌻 The nurse should provide support while maintaining clear expectations regarding nutritional goals.

✅ Focus on the client's underlying feelings of dysphoria

🌻 Addressing the client’s underlying emotional distress is important because anorexia nervosa is associated with depression, anxiety, low self-esteem, and distorted body image.

🌻 The client reports feeling depressed and believes they are “fat” despite being significantly underweight.

🌻 Exploring these feelings helps identify triggers for restrictive behaviors and promotes healthier coping mechanisms.

🌻 Psychological support is essential along with nutritional restoration for long-term recovery.

Parameters to Monitor

✅ Weight on a daily basis

🌻 Daily weight monitoring evaluates progress toward nutritional rehabilitation and weight restoration.

🌻 The client’s BMI of 15 indicates severe malnutrition requiring close monitoring.

🌻 Weight trends help determine whether the treatment plan is effective and whether nutritional goals are being achieved.

🌻 Monitoring must be careful because rapid nutritional changes can increase the risk of refeeding complications.

✅ Cardiac function with ECG

🌻 ECG monitoring is necessary because the client has sinus bradycardia and electrolyte abnormalities, including potassium of 2.8 mEq/L and magnesium of 1.2 mEq/L.

🌻 Low potassium and magnesium levels increase the risk of life-threatening cardiac dysrhythmias.

🌻 Severe malnutrition can weaken cardiac muscle and cause conduction abnormalities.

🌻 Monitoring cardiac function helps identify complications early and guide treatment.

Potential conditions

❌ Bulimia nervosa

🌻 Bulimia nervosa involves episodes of binge eating followed by compensatory behaviors such as vomiting, excessive exercise, or misuse of laxatives.

🌻 Clients with bulimia often have a normal or slightly increased body weight, unlike this client who has severe underweight status with a BMI of 15.

🌻 Physical findings may include dental enamel erosion, enlarged parotid glands, sore throat, and electrolyte abnormalities caused by repeated vomiting.

🌻 This client did report vomiting after being forced to eat, but the primary pattern is restriction and food avoidance, which supports anorexia nervosa rather than bulimia nervosa.

❌ Binge eating disorder

🌻 Binge eating disorder involves repeated episodes of consuming large amounts of food with a feeling of loss of control, without regular compensatory behaviors.

🌻 Clients commonly experience overweight or obesity due to excessive caloric intake.

🌻 The client demonstrates the opposite pattern, with severe restriction, weight loss, and avoidance of foods.

🌻 The absence of binge episodes makes this diagnosis unlikely.

❌ Avoidant/restrictive food intake disorder (ARFID)

🌻 Avoidant/restrictive food intake disorder (ARFID) involves food restriction due to factors such as lack of interest in eating, sensory sensitivity, or fear of negative consequences like choking or vomiting.

🌻 ARFID does not typically involve a distorted body image or fear of being fat.

🌻 This client restricts food because they feel “fat” compared with others, which is a key feature of anorexia nervosa.

🌻 The psychological motivation behind the restriction differentiates anorexia nervosa from ARFID.

Actions

❌ Encourage the client to limit fasting

🌻 Limiting fasting is not the goal because the client should not continue restrictive eating behaviors.

🌻 The priority is restoring adequate nutrition and preventing complications of starvation.

❌ Accept the client’s belief about "forbidden" foods

🌻 Accepting distorted beliefs about foods reinforces the eating disorder.

🌻 The nurse should acknowledge the client’s feelings while helping challenge unhealthy food restrictions.

❌ Provide the client with foods that have a variety of textures

🌻 Food texture variety is not the priority intervention for anorexia nervosa.

🌻 The priority is adequate caloric intake, structured meals, and addressing psychological factors.

Parameters

❌ Calcium level

🌻 Calcium monitoring may be relevant in long-term malnutrition, but it is not the priority concern in this client.

🌻 Cardiac monitoring and weight restoration are more urgent due to current instability.

❌ Vital signs every 8 hr

🌻 Routine vital sign monitoring every 8 hours is insufficient because the client already has hypotension and bradycardia.

🌻 More frequent monitoring may be required due to the risk of deterioration.

❌ Behavior 15 min after meals

🌻 Monitoring after meals is commonly associated with bulimia nervosa to observe for purging behaviors.

🌻 This client’s primary disorder is restrictive eating consistent with anorexia nervosa.

Distractor Analysis :

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Answer 4

Correct Answers:

To cremate the client's body

Rationale :

🌻 Cremation is the expected request from the family of a client who is a devout follower of Hinduism because many Hindu traditions view cremation as a way to allow the soul to transition from the physical body.

🌻 Hindu beliefs commonly emphasize the importance of separating the spiritual self (soul) from the physical body after death.

🌻 The nurse should provide culturally sensitive postmortem care by respecting the family’s religious beliefs, rituals, and preferences.

🌻 The family may request that the body be handled with respect and dignity before arrangements are made for cremation.

🌻 The nurse should communicate with the family to determine any specific practices they want followed during postmortem care.

🌻 Respecting cultural and spiritual preferences supports the family’s grieving process and promotes patient dignity after death.

🌻 Understanding common religious practices helps nurses provide holistic and individualized end-of-life care.

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Answer 5

Correct Answers:

''Is your name Victoria?"

Rationale :

🌼 Asking "Is your name Victoria?" helps verify the client’s identity before medication administration by confirming one of the required client identifiers.

🌼 The nurse should use at least two identifiers, such as the client’s name and date of birth or medical record number, before administering any medication.

🌼 Confirming the client’s name reduces the risk of wrong-client medication errors and promotes safe medication practices.

🌼 The nurse should compare the client’s response with the identification band and medication administration record (MAR) before giving the medication.

🌼 Identity verification is a critical step in the rights of medication administration.

🌼 Using approved identifiers protects clients from preventable adverse events.

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Answer 6

Correct Answers

Blank 1 Correct Option: Systemic lupus erythematosus (SLE).
Blank 2 Correct Option: Encourage client to avoid direct sunlight.
Blank 3 Correct Option: Anticipate administering prescribed immunosuppressant medication.
Blank 4 Correct Option: Urine protein.
Blank 5 Correct Option: Erythrocyte sedimentation rate.

Rationale :

Potential Condition

✅ Systemic lupus erythematosus (SLE)

🌼 Systemic lupus erythematosus (SLE) is the most likely condition because the client presents with fever, joint discomfort, malaise, bilateral macular cheek rash, elevated ESR, and mild proteinuria.

🌼 The malar (butterfly) rash on the cheeks is a classic finding associated with SLE and results from autoimmune inflammation affecting the skin.

🌼 SLE is a chronic autoimmune disorder in which the immune system attacks healthy tissues, causing inflammation in multiple organs.

🌼 The client’s elevated erythrocyte sedimentation rate (ESR) indicates an inflammatory process consistent with autoimmune activity.

🌼 Mild proteinuria suggests possible early renal involvement (lupus nephritis), which is a common complication of SLE.

🌼 The decreased WBC count, RBC count, hemoglobin, and platelets can occur due to autoimmune destruction or bone marrow suppression associated with SLE.

🌼 Management focuses on controlling inflammation, preventing organ damage, and monitoring for disease progression.

Actions to Take

✅ Encourage client to avoid direct sunlight

🌼 Clients with SLE should avoid excessive sunlight exposure because ultraviolet (UV) light can trigger or worsen disease flares.

🌼 UV exposure can increase autoimmune activity and worsen skin manifestations such as the malar rash.

🌼 The nurse should teach the client to use sun protection measures, including sunscreen, protective clothing, and avoiding peak sunlight hours.

🌼 Reducing UV exposure helps prevent worsening of symptoms and promotes disease control.

✅ Anticipate administering prescribed immunosuppressant medication

🌼 Immunosuppressants are used in SLE to reduce abnormal immune system activity and decrease inflammation.

🌼 SLE occurs because the immune system attacks normal body tissues, leading to widespread inflammatory damage.

🌼 Medications that suppress immune activity help control symptoms and prevent complications involving organs such as the kidneys.

🌼 The nurse should monitor for infection risk because immunosuppressive therapy decreases immune defenses.

Parameters to Monitor

✅ Urine protein

🌼 Monitoring urine protein is important because SLE can cause lupus nephritis, an inflammatory kidney complication.

🌼 Proteinuria may indicate kidney involvement and worsening autoimmune damage.

🌼 Early detection allows prompt treatment to prevent progression to renal impairment.

🌼 The nurse should monitor urinalysis findings and renal function tests as prescribed.

✅ Erythrocyte sedimentation rate

🌼 Monitoring ESR helps evaluate the level of inflammation and disease activity in clients with SLE.

🌼 An elevated ESR may indicate increased autoimmune inflammation.

🌼 Trends in ESR can help determine whether treatment is controlling the inflammatory response.

🌼 Monitoring inflammatory markers supports evaluation of therapeutic effectiveness.

Conditions

❌ Psoriasis

🌼 Psoriasis is an incorrect choice because it is a chronic inflammatory skin disorder characterized by thick, scaly plaques, usually found on areas such as the elbows, knees, and scalp.

🌼 Psoriasis does not typically cause malar facial rash, proteinuria, or systemic autoimmune findings such as this client’s elevated ESR and abnormal blood counts.

❌ Sickle cell crisis

🌼 Sickle cell crisis is incorrect because it occurs due to abnormal hemoglobin causing red blood cells to sickle, leading to severe pain episodes and tissue ischemia.

🌼 Clients experiencing sickle cell crisis commonly have extremity pain, vaso-occlusive symptoms, and a history of sickle cell disease, which are not present in this client.

❌ Osteomyelitis

🌼 Osteomyelitis is incorrect because it is an infection of bone tissue, usually caused by bacteria entering the bone.

🌼 Clients with osteomyelitis typically present with localized bone pain, swelling, warmth, and possible drainage, rather than a butterfly rash and autoimmune laboratory findings.

Actions

❌ Prepare client for light therapy

🌼 Light therapy is associated with conditions such as psoriasis, not SLE.

🌼 UV exposure may actually worsen SLE symptoms.

🌼 Clients with SLE require sun protection, not intentional UV treatment.

❌ Ensure that client has intake of at least 200 mL/hr

🌼 High fluid intake is not a specific intervention for SLE.

🌼 Aggressive hydration is more commonly associated with conditions such as sickle cell crisis or prevention of kidney complications in certain situations.

🌼 SLE management focuses on immune control and monitoring organ involvement.

❌ Initiate contact precautions

🌼 Contact precautions are not indicated because SLE is not a contagious condition.

🌼 Infection prevention focuses on monitoring and protecting clients receiving immunosuppressive therapy.

🌼 Standard precautions remain appropriate unless another infection is identified.

Parameters

❌ Skin lesions

🌼 Skin findings are important in SLE, but monitoring urine protein and inflammatory markers provides better information about systemic disease activity.

🌼 SLE can affect internal organs, making systemic monitoring a priority.

❌ Vital signs every 4 hr

🌼 Vital signs should be monitored, especially during acute illness, but they are not the best indicators of SLE disease progression.

🌼 Disease activity is better assessed through laboratory findings and organ involvement.

❌ Extremity warm to touch

🌼 Extremity temperature is not a primary monitoring parameter for SLE.

🌼 This assessment is more relevant for conditions involving circulation problems, infection, or vascular compromise.

Distractor Analysis :

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Answer 7

Correct Answers:

Reinforce loose dressing around the tube.
Ensure the chest tube remains below the level of the client's chest.

Rationale :

Reinforce loose dressing around the tube

🖊️ Reinforcing a loose chest tube dressing is appropriate because the client disturbed the dressing by lifting the edges to scratch underneath the tape.

🖊️ A secure and intact dressing helps maintain a closed chest drainage system and reduces the risk of air entering the pleural space.

🖊️ A loose or compromised dressing can increase the risk of infection at the chest tube insertion site.

🖊️ The nurse should assess the insertion site for redness, swelling, drainage, or signs of infection.

🖊️ Maintaining proper chest tube site care supports healing after a lung lobectomy.

Ensure the chest tube remains below the level of the client's chest

🖊️ Keeping the chest tube below the level of the chest is essential because gravity allows drainage of air and fluid from the pleural space into the collection chamber.

🖊️ The client’s chest tube should remain positioned correctly during activities such as ambulation to prevent interruption of drainage.

🖊️ Elevating the drainage system above the chest can allow fluid to flow backward toward the pleural space, increasing the risk of complications.

🖊️ Proper placement promotes effective functioning of the water-seal drainage system.

🖊️ The nurse should also ensure tubing is free from dependent loops or kinks that could obstruct drainage.

Distractor Analysis :

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Answer 8

Correct Answers:

Blood creatinine 9 mg/dL (0.6 to 1.3 mg/dL)

Rationale :

👉 Blood creatinine of 9 mg/dL is an expected finding in a client with end-stage kidney disease (ESKD) because the kidneys are unable to effectively filter and eliminate creatinine from the blood.

👉 Creatinine is a waste product produced by normal muscle metabolism, and it is normally removed through glomerular filtration in the kidneys.

👉 In severe renal impairment, decreased filtration causes creatinine levels to rise significantly.

👉 A creatinine level of 9 mg/dL indicates severe reduction in kidney function and is consistent with advanced renal failure.

👉 Clients with ESKD often require dialysis to remove accumulated waste products and maintain fluid and electrolyte balance.

👉 The nurse should monitor related findings such as BUN, potassium, fluid status, and signs of uremia.

Distractor Analysis :

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Answer 9

Correct Answers:

Rigid expectations of behavior

Rationale :

🌻 Rigid expectations of behavior are a common characteristic of some child abuse perpetrators because they may have unrealistic beliefs about how children should behave and respond harshly when expectations are not met.

🌻 Perpetrators may demonstrate a need for control, perfection, and strict obedience from the child.

🌻 They may have difficulty understanding normal child development and expect children to behave beyond their developmental abilities.

🌻 Failure of the child to meet these expectations can lead to frustration, anger, and abusive responses.

🌻 These individuals may use excessive discipline or punishment as a way to maintain control over the child.

🌻 The nurse should teach parents that healthy discipline involves realistic expectations, communication, and age-appropriate guidance.

🌻 Recognizing rigid behavioral expectations helps identify families who may benefit from parenting education and support.

🌻 Early identification of risk factors allows nurses to promote child safety and prevention of abuse.

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Answer 10

Correct Answers

Decrease the IV flow rate. [ Contraindicated ]
Monitor fetal heart rate. [ Essential ]
Place the client in left lateral position. [ Essential ]
Assist with administration of ampicillin IV. [ Essential ]
Request a prescription for ephedrine. [ Contraindicated ]

Rationale :

Decrease the IV flow rate

🌸 Decreasing IV fluids after epidural placement is contraindicated because epidural anesthesia can cause vasodilation and maternal hypotension.

🌸 Clients receiving epidurals require adequate IV fluid administration to reduce the risk of a sudden drop in blood pressure.

🌸 Reduced maternal blood pressure can decrease uteroplacental perfusion and affect fetal oxygenation.

Monitor fetal heart rate

🌸 Monitoring fetal heart rate (FHR) is essential after epidural placement because maternal hypotension can reduce placental blood flow and cause fetal compromise.

🌸 Epidural anesthesia may cause changes in maternal blood pressure, which can affect the fetus.

🌸 The client’s tracing changed from moderate variability to minimal variability with early decelerations, requiring close fetal assessment.

🌸 Continuous or frequent FHR monitoring helps identify signs of fetal distress early.

🌸 The nurse should assess fetal response during and after anesthesia administration.

🌸 Prompt recognition of abnormal FHR patterns allows timely interventions to improve fetal oxygenation.

🌸 FHR monitoring is a priority nursing action following epidural anesthesia.

Place the client in left lateral position

🌸 Left lateral positioning is essential because it promotes uteroplacental perfusion and reduces compression of the inferior vena cava.

🌸 Epidural anesthesia can cause maternal hypotension, and repositioning can help improve blood return to the heart.

🌸 This position supports adequate oxygen delivery to the fetus.

🌸 The left lateral position is commonly used when fetal heart rate changes occur after epidural administration.

🌸 Proper positioning may improve fetal oxygenation and maternal blood pressure.

🌸 The nurse should avoid positions that worsen vena cava compression.

🌸 Maintaining optimal positioning supports safe labor progression.

Assist with administration of ampicillin IV

🌸 Ampicillin IV is essential because the client tested positive for group B streptococcus (GBS) at 37 weeks.

🌸 GBS colonization places the newborn at risk for developing early-onset neonatal infection during vaginal birth.

🌸 Intrapartum antibiotic prophylaxis reduces transmission of GBS from mother to newborn.

🌸 The nurse should administer the prescribed antibiotic during labor as ordered.

🌸 Treatment is especially important because the client’s membranes have ruptured, increasing exposure risk.

🌸 Preventing neonatal infection is a major priority during labor management.

🌸 Timely antibiotic administration improves newborn outcomes.

Request a prescription for ephedrine

🌸 Ephedrine is not indicated unless the client develops maternal hypotension after epidural anesthesia.

🌸 The client’s blood pressure remains within an acceptable range (120/80 mm Hg at 1215).

🌸 Administering vasopressors without evidence of hypotension is unnecessary and may cause adverse cardiovascular effects.

Distractor Analysis :

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Nursing Intervention	Essential	Contraindicated
Decrease the IV flow rate.
Monitor fetal heart rate.
Place the client in left lateral position.
Assist with administration of ampicillin IV.
Request a prescription for ephedrine.

QLexNursing

1 :
A nurse is assisting with the care of a client who has had a prostatectomy.

Answer Options

2 :
A nurse is reinforcing discharge teaching with the caregiver of a client who has dependent personality disorder. Which of the following instructions should the nurse include in the teaching?

3 :
A nurse is assisting with the care of an 18-year-old client who was recently admitted.

Correct Answers

4 :
A nurse is assisting in providing postmortem care for a client who was a devout follower of Hinduism. Which of the following requests should the nurse anticipate from the client's family?

5 :
A nurse is preparing to administer a medication to a client. To help verify the client's identity, which of the following questions should the nurse ask the client?

6 :
A nurse is contributing to the plan of care for a client who was recently admitted to the medical-surgical unit.

Correct Answers

7 :
A nurse is assisting with the care of a client.

Answer Options

8 :
A nurse is reviewing the laboratory report of a 60-year-old male client who has end-stage kidney disease. Which of the following results should the nurse expect?

9 :
A nurse is discussing risk factors for child abuse with members of a parenting group. The nurse should identify which of the following findings as a characteristic of perpetrators of child abuse?

10 :
A nurse is assisting with the care of a client who is in active labor.

Correct Answers

QLexNursing

1 : A nurse is assisting with the care of a client who has had a prostatectomy.

Answer Options

2 : A nurse is reinforcing discharge teaching with the caregiver of a client who has dependent personality disorder. Which of the following instructions should the nurse include in the teaching?

3 : A nurse is assisting with the care of an 18-year-old client who was recently admitted.

Correct Answers

4 : A nurse is assisting in providing postmortem care for a client who was a devout follower of Hinduism. Which of the following requests should the nurse anticipate from the client's family?

5 : A nurse is preparing to administer a medication to a client. To help verify the client's identity, which of the following questions should the nurse ask the client?

6 : A nurse is contributing to the plan of care for a client who was recently admitted to the medical-surgical unit.

Correct Answers

7 : A nurse is assisting with the care of a client.

Answer Options

8 : A nurse is reviewing the laboratory report of a 60-year-old male client who has end-stage kidney disease. Which of the following results should the nurse expect?

9 : A nurse is discussing risk factors for child abuse with members of a parenting group. The nurse should identify which of the following findings as a characteristic of perpetrators of child abuse?

10 : A nurse is assisting with the care of a client who is in active labor.

Correct Answers

1 :
A nurse is assisting with the care of a client who has had a prostatectomy.

2 :
A nurse is reinforcing discharge teaching with the caregiver of a client who has dependent personality disorder. Which of the following instructions should the nurse include in the teaching?

3 :
A nurse is assisting with the care of an 18-year-old client who was recently admitted.

4 :
A nurse is assisting in providing postmortem care for a client who was a devout follower of Hinduism. Which of the following requests should the nurse anticipate from the client's family?

5 :
A nurse is preparing to administer a medication to a client. To help verify the client's identity, which of the following questions should the nurse ask the client?

6 :
A nurse is contributing to the plan of care for a client who was recently admitted to the medical-surgical unit.

7 :
A nurse is assisting with the care of a client.

8 :
A nurse is reviewing the laboratory report of a 60-year-old male client who has end-stage kidney disease. Which of the following results should the nurse expect?

9 :
A nurse is discussing risk factors for child abuse with members of a parenting group. The nurse should identify which of the following findings as a characteristic of perpetrators of child abuse?

10 :
A nurse is assisting with the care of a client who is in active labor.