A patient who has sustained second-degree facial burns and a facial fracture is undergoing reconstructive surgery. The nursing diagnosis for this patient is disturbed body image related to disfigurement
An appropriate nursing intervention related to this diagnosis would include which of the following?
A) Referral to a speech therapist
B) Gradually add soft foods to the diet
C) Administer analgesics as prescribed
D) Teach how to use and care for the prosthesis
Ans: D
Feedback: Reinforcement of the patient's successful coping strategies improves self-esteem. If prosthetic devices are used, the patient is taught how to use and care for them to gain a sense of greater independence. This is an intervention which relates to disturbed body image. Options A, B, and C do not relate to the diagnosis of disturbed body image.
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When performing a physical examination, safety must be considered to protect the examiner and the patient against the spread of infection. Which of these statements describes the most appropriate action the nurse should take when performing
a physical examination? a. Washing one's hands after removing gloves is not necessary, as long as the gloves are still intact. b. Hands are washed before and after every physical patient encounter. c. Hands are washed before the examination of each body system to prevent the spread of bacteria from one part of the body to another. d. Gloves are worn throughout the entire examination to demonstrate to the patient concern regarding the spread of infectious diseases.
The educator of a geriatric, subacute medical unit in a hospital is oriented new staff and teaching orientees' strategies for communicating with older adults with impaired hearing. Which of the following teaching points is most justifiable?
A) "Speak slowly and directly to these clients." B) "Avoid complex or abstract ideas when you're talking." C) "Increase the volume of your speech as much as possible." D) "Choose simple, short words to minimize confusion."
The nurse is preparing to assess the abdomen of a client who is complaining of abdominal pain. Which statement by the nurse would be most appropriate?
A) "I'm going to examine the area where you're having pain first to get a better picture of what's going on." B) "Before I get ready to examine the painful area, I will let you know in plenty of time." C) "You don't need to worry about anything. I will make sure to be very gentle during the exam." D) "Since you're having pain in a certain area, I won't have to do a very thorough exam there."
The parent of an 8-year-old asks the nurse about any special nutritional needs for children in this age group. The nurse mentions that children in this age group need to do which one of the following?
a. Increase their intake of B vitamins. b. Significantly increase iron intake. c. Maintain a sufficient intake of protein, and vitamins A and C. d. Increase carbohydrates to meet increased energy needs.