NURS 218 Personal Care of Head Emergencies at Baton Rouge Community College
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Free NURS 218 Personal Care of Head Emergencies at Baton Rouge Community College Questions
A nurse provides teaching to the family of a young adult with autism. Which interventions should the nurse include? Select all that apply.
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Protect from self-injury
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Assign a variety of caregivers
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Provide positive reinforcement for eye contact
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Provide client with familiar objects
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Work individually with the client
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Suggest diversion when anxiety rises
Explanation
A. Protect from self-injury Individuals with autism may engage in self-injurious behavior, such as head-banging or biting themselves, often due to frustration or difficulty with communication. It's crucial to protect the individual from harm and implement interventions to reduce self-injury, such as providing a safe environment and using behavioral strategies.
C. Provide positive reinforcement for eye contact Individuals with autism may have difficulty making eye contact. Using positive reinforcement to encourage eye contact can help improve social communication skills. Reinforcing small steps toward this behavior supports gradual progress.
D. Provide client with familiar objects Familiar objects can provide comfort and help the individual feel safe, especially in unfamiliar settings. Familiar items may act as a coping mechanism, reduce anxiety, and offer reassurance.
E. Work individually with the client Working one-on-one with the client allows for tailored interventions that can address the individual's unique needs. It provides the opportunity for focused teaching and support, which is often more effective for individuals with autism who may have difficulty in group settings.
F. Suggest diversion when anxiety rises Individuals with autism may experience heightened anxiety in certain situations. Offering diversionary activities, such as fidget toys, deep breathing exercises, or sensory activities, can help redirect attention and reduce anxiety.
A nurse is caring for a client following a total laryngectomy. Which of the following is the priority nursing problem for the client?
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Patency of the intravenous line
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Need for suctioning
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Integrity of the dressing
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Level of pain
Explanation
After a total laryngectomy, ensuring airway patency is the priority. The patient will likely have a tracheostomy or a stoma, and suctioning is necessary to clear any mucus or secretions that could obstruct the airway. Difficulty breathing or labored breathing due to secretions can quickly become a life-threatening situation, so suctioning to clear the airway takes precedence over other concerns.
When preparing to interview a patient diagnosed with narcissistic personality disorder, which assessment finding would the nurse anticipate?
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Charm, drama, seductiveness; seeking admiration
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Preoccupation with minute details, perfectionism
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Difficulty being alone; indecisive, submissiveness
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Grandiosity, self-importance, and a sense of entitlement
Explanation
Narcissistic personality disorder (NPD) is characterized by a pervasive pattern of grandiosity, self-importance, and a strong sense of entitlement. Individuals with NPD often believe they are superior to others and require excessive admiration. They may lack empathy and have difficulty recognizing the needs and feelings of others. The most prominent features of NPD are grandiosity and an inflated sense of their own importance, which align with the characteristics described in option D.
The nurse at a university health center leads a dialogue with female freshmen about rape and sexual assault. One student says, "If I avoid strangers or situations where I am alone outside at night, I'll be safe from sexual attacks." What should be your best response as the nurse?
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"I am glad you have this excellent safety plan. Would others like to comment?"
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"It's better to walk with someone or call security when you enter or leave a building."
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"Sexual assaults are more often perpetrated by acquaintances. Let's discuss ways to prevent that."
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"Your plan is not adequate. You could still be raped or sexually assaulted."
Explanation
While avoiding strangers and risky situations can be a helpful strategy, it is important to emphasize that most sexual assaults are perpetrated by people the victim knows, such as acquaintances, friends, or even intimate partners. This response shifts the focus to a more comprehensive discussion about prevention, including recognizing warning signs and establishing boundaries with acquaintances. It helps challenge misconceptions about where assaults occur and promotes a broader understanding of sexual violence.
A 79-year-old patient is brought to the hospital by a family member and diagnosed with pneumonia. The patient is 5 feet 6 inches and weighs 93 pounds. The patient's clothes are old, dirty, and have holes. The patient also has a sacral pressure ulcer. Which question should the nurse ask to best assess for abuse or neglect?
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"How much money do you have in your bank account?"
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"Describe a typical day at home. What do you eat, and what do you do?"
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"Who buys your clothes?"
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"How long have you lived with your children?"
Explanation
Asking about the patient's daily routine can provide insight into their living conditions, ability to care for themselves, and potential neglect. This question opens up a conversation about the patient's overall well-being and their environment, which can help the nurse assess for signs of neglect, such as poor nutrition, lack of proper clothing, and inadequate care. This is a non-confrontational way to gather important information regarding possible abuse or neglect.
A client tells the nurse, "My husband lost his job. He's abusive only when he drinks too much. His family was like that when he was growing up. He always apologizes and regrets hurting me." What risk factor was most predictive for the husband to become abusive?
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Poverty
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Loss of employment
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Abuse of alcohol
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History of family violence
Explanation
A history of family violence is one of the most predictive risk factors for an individual to become abusive in relationships. Growing up in an environment where violence or abuse was present can normalize these behaviors and increase the likelihood of repeating them. While alcohol abuse and other stressors such as poverty or job loss may exacerbate violent tendencies, the most significant predictor in this scenario is the husband's history of family violence. This history increases the risk of him displaying abusive behaviors in adulthood.
When caring for a patient with Autistic disorder, the nurse expects to see impairments in which areas? Select all that apply.
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Behaviors
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Social interactions
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Communication abilities
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Appearance and dress
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Physical size
Explanation
A. Behaviors Children with autism often exhibit repetitive behaviors or restrictive patterns of behavior, such as hand-flapping, rocking, or a rigid adherence to routines. These behaviors are part of the diagnostic criteria for autism spectrum disorder.
B. Social interactions One of the core features of autism is difficulty with social interactions. Individuals with autism often have trouble understanding social cues, making eye contact, and engaging in reciprocal social interactions, which can impact relationships and social functioning.
C. Communication abilities Many individuals with autism have delayed or impaired communication skills. This can include difficulties with both verbal and nonverbal communication, such as using and understanding language, gestures, and facial expressions. Some individuals may be nonverbal or have difficulty with spoken language.
A nurse is providing teaching to an adolescent patient who is to begin taking atomoxetine (Strattera) for Attention Deficit Hyperactivity Disorder. The nurse should instruct the patient to monitor for which adverse effect?
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Increased appetite
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Somnolence
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Yellowing skin
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Weight gain
Explanation
Atomoxetine (Strattera) is a non-stimulant medication used to treat Attention Deficit Hyperactivity Disorder (ADHD). A rare but serious adverse effect of atomoxetine is liver damage, which can present with symptoms like yellowing of the skin (jaundice) or eyes. The nurse should instruct the patient to monitor for any signs of liver problems, such as yellowing of the skin, and report them immediately, as this could indicate liver toxicity.
A client with diagnosed early-stage laryngeal cancer is being monitored for progression. Which new symptom should prompt the nurse to notify the provider immediately as it indicates disease progression?
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Dysphagia and shortness of breath
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Mild throat dryness
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A cough occurring at night only
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Increasing hoarseness over 2 days
Explanation
Dysphagia (difficulty swallowing) and shortness of breath are concerning symptoms that may indicate progression of laryngeal cancer, particularly if the tumor is obstructing the airway or affecting the swallowing mechanism. These symptoms suggest that the cancer may be enlarging or invading structures involved in swallowing and respiration, which requires immediate medical attention. While other symptoms such as mild throat dryness, a cough at night, or hoarseness may also be related to the cancer, they are less urgent compared to symptoms affecting the patient's ability to breathe and swallow.
A suicidal client is placed on one-to-one observation. When the nurse accompanies the client to the bathroom, the client loudly states, "I'm sick of being followed around and treated like a child who has misbehaved and cannot be trusted." Which statement would be the best therapeutic response by the nurse?
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"Since this is upsetting to you, leave the door open and I'll wait outside for you."
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"Being angry and uncooperative will not change anything. I can't leave a suicidal client alone."
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"You don't have to shout. I trust you, but I cannot change the rules for you."
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"I understand that you do not like this, but I must be able to see you at all times to make sure you are safe."
Explanation
This response is therapeutic because it acknowledges the client's feelings while reinforcing the rationale for the safety measures. The nurse empathizes with the client’s frustration and clarifies the necessity of the observation for the client's safety due to the risk of suicide. It maintains a balance of compassion and professionalism, helping to foster trust while emphasizing the importance of safety protocols.
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