After being diagnosed with cancer, your patient appears angry. At this point it would be appropriate for you to assess for which kind of distress?
a. Environmental
b. Developmental
c. Physical
d. Spiritual
D
Rationale: Patients facing stressful health care–related events may also experience spiritual dis-tress. Illness states can place a patient in a position that forces consideration of the fragile nature of life. Resulting from a potential life or death experience or a life-changing event, such as be-coming paralyzed; losing a limb, sight, or hearing; or learning to live with a debilitating illness, spiritual distress may take on many manifestations. Much as in the grief process, the patient may display anger, blame, bargaining, or denial or may overtly cling to a spiritual guide. As RN, you assess for spiritual distress and implement interventions that will help the patient cope, such as facilitating the patient's spiritual connection either through a referral or just by respecting per-sonal wishes. Often the patient will require a spiritual guide by his or her side.
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A patient, age 45, has worked as a basket weaver for the past 10 years. She is being seen at the clinic for symptoms of carpal tunnel syndrome. Collection of subjective data might include
a. complaints of burning pain or tingling in the hands. b. edema of the fingers. c. radicular pain. d. complaints of weight loss and fatigue.
An intervention appropriate to use for both clients with delirium and clients with dementia is
a. speaking in a loud, firm voice. b. touching the client before speaking. c. reorienting the client to the health care worker with each contact. d. for aggression, using physical restraint in lieu of medication.
The nurse prepares to insert a small-bore intestinal feeding tube. Which instruction does the nurse provide to the nursing assistant to assist with preparation?
1. Immerse feeding tube in an ice bath. 2. Cut adhesive tape to length of 10 cm. 3. Inspect the client's nares for irritation. 4. Remove guide wire from feeding tube.
When participating in the planning of care of a postpartum client who plans to breast-feed her infant, the nurse realizes the importance of including which of the following in the teaching plan to prevent the development of mastitis?
1. Offer only one breast at each feeding. 2. Massage distended areas as the infant nurses. 3. Cleanse nipples with a mild antibacterial soap before and after infant feedings. 4. Express and discard milk from the affected breast at the first signs of mastitis.