Nursing Process Practice Questions

Correct Answer: C

Rationale: The correct response is C: �Would you like to meet with your family and your physician about this matter?� Rationale: 1. Involving the family and physician ensures a collaborative decision-making process. 2. It respects the client's autonomy and involves them in the decision-making process. 3. It promotes open communication and support from loved ones. 4. It addresses the client's concerns about continuing treatment based on family wishes. Summary: A: Refers to psychological support, but the client's primary concern is medical treatment decisions. B: Involves religious support, which may not align with the client's beliefs or address the medical decision. D: Acknowledges the client's feelings but lacks a collaborative approach involving family and healthcare team.

Correct Answer: B

Rationale: Severe and extensive hemolysis leads to the release of large amounts of hemoglobin into the bloodstream, causing hemoglobinemia. This can result in hemoglobinuria, leading to acute renal failure and ultimately shock. Shock is the correct answer as it is a severe consequence of extensive hemolysis. Leg ulcers (A) may occur in conditions like peripheral arterial disease. Priapism (C) is unrelated to hemolysis. Compromised growth (D) is not a common consequence of hemolysis.

Correct Answer: C

Rationale: The correct answer is C: 1� to 1.5�. When irrigating a colostomy, the client should insert the lubricated catheter about 1� to 1.5� into the stoma. This depth allows for effective irrigation of the colon without causing discomfort or damage. Inserting the catheter too shallow (choice A) may not reach the colon, while inserting it too deep (choices B and D) can cause injury or perforation. Therefore, the optimal depth of 1� to 1.5� ensures proper irrigation while minimizing risks of complications.

Correct Answer: A

Rationale: Correct Answer: A - Cerebral edema Rationale: 1. SIADH leads to water retention and dilutional hyponatremia. 2. Diuretic therapy aims to increase urine output and correct fluid imbalance. 3. If the client does not comply, excessive water retention can lead to cerebral edema. 4. Cerebral edema is a serious complication that can cause neurological deficits. Summary: - B: Severe hyperkalemia is unlikely as diuretics would help excrete excess potassium. - C: Hypovolemic shock is not expected as fluid restriction may prevent rapid volume loss. - D: Tetany is not a direct consequence of non-compliance with treatment for SIADH.

Correct Answer: A

Rationale: The correct answer is A: Prostate-specific antigen, which is used to screen for prostate cancer. PSA is a protein produced by the prostate gland, and elevated levels may indicate prostate cancer. Choice B is incorrect as PSA is specific to the prostate, not protein levels. Choice C is incorrect as pneumococcal strep antigen is related to pneumonia, not PSA. Choice D is incorrect as Papanicolua-specific antigen is not a recognized term, and PSA is not used to screen for cervical cancer.