A client being treated for a myocardial infarction has been transferred from the intensive care unit to
a step-down unit. She uses the call bell as often as every 15 minutes.
She makes a seemingly small
request or complains each time a staff member is summoned. Several staff tell the primary nurse that
the client is "obnoxious" and that they feel inadequate because they can never seem to satisfy her
needs. The primary nurse decides to intervene directly with the client. The most appropriate way to
begin problem solving would be to say
a. "I am wondering if you are feeling anxious about your condition and being left
alone.".
b. "The staff are concerned that you are not satisfied with the care you are
receiving.".
c. "Let's talk about why you use your call light so frequently.".
d. "I think you are giving staff a negative message.".
A
This opening conveys the nurse's willingness to listen to the client's feelings and an understanding
of the commonly seen concern about not having a nurse always nearby as in the intensive care unit.
Verbalization is an effective outlet for anxiety. Also, knowing that staff understand her anxiety and
will meet her needs without being summoned so frequently can reduce the client's anxiety level
from severe to moderate or lower.
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A patient with small cell lung cancer (SCLC) has developed a paraneoplastic syndrome called Cushing syndrome. Based on this new complication, the nurse will likely assess which of the following clinical manifestations of Cushing syndrome?
A) Weight gain, moon face, buffalo hump, and purple striae on the abdomen B) Bilateral edema in the arms, swollen face, and protruding eyes C) Severe bone/joint pain, nausea/vomiting, and polyuria D) Tetany, new-onset seizure activity, emotional lability, and extrapyramidal symptoms
Which word describes this thought process?
A 29-year-old woman comes to your office. As you take the history, you notice that she is speaking very quickly, and jumping from topic to topic so rapidly that you have trouble following her. You are able to find some connections between ideas, but it is difficult. A) Derailment B) Flight of ideas C) Circumstantiality D) Incoherence
Which of the following statements made by a nurse puts the nurse at risk for assault of the client?
1. "You will be sorry if you don't agree to take this medication." 2. "You can't refuse this medication if you really want to feel better." 3. "I'll be so disappointed in you if you don't take your medication." 4. "I'll tell your son you aren't cooperating if you don't take your medication."
MC The client is complaining of episodes of intense fear without any identifiable basis. During the episodes the client says he experiences shortness of breath and palpitations
A. Borderline personality disorder B. Panic disorder C. Schizophrenia D. Bipolar disorder