test bank foundations of nursing

Correct Answer: B

Rationale: The correct answer is B: What do you call your problem? In the explanatory model, this question helps the nurse understand the patient's perspective and cultural beliefs about their illness. By asking how the patient labels their illness, the nurse gains insight into the patient's understanding of the illness, which can influence their treatment adherence and outcomes. The other options are incorrect because: A: How should your sickness be treated? - This question focuses on treatment preferences rather than understanding the patient's beliefs. C: How does this illness work inside your body? - This question is more aligned with the biomedical model, seeking physiological explanations rather than patient perspectives. D: What do you fear most about your sickness? - While important for assessing emotional aspects, this question does not directly address the patient's explanatory model.

Correct Answer: A

Rationale: The correct answer is A: Ineffective Airway Clearance. In a patient with AIDS and PCP, maintaining clear airways is crucial to prevent respiratory distress and hypoxia. Pneumocystis pneumonia can cause thick secretions and mucus plugging, leading to difficulty breathing. Ensuring effective airway clearance is a priority to optimize oxygenation and prevent respiratory complications. Impaired oral mucous membranes (B) and imbalanced nutrition (C) are important considerations but not as immediate as airway clearance. Activity intolerance (D) may be a concern for the patient but ensuring adequate oxygenation takes precedence.

Correct Answer: B

Rationale: The correct answer is B: Provide the patient with relevant information about expected recovery. This option addresses the patient's anxiety by providing her with concrete information about what to expect after the procedure. By knowing the expected recovery process, the patient can feel more in control and prepared, which can help alleviate fears. Summary: A: Providing written material on the procedure does not directly address the patient's fears about the upcoming surgery and cancer diagnosis. C: Giving the patient current information on breast cancer survival rates may increase anxiety rather than alleviate it, as it focuses on statistics rather than the individual patient's concerns. D: Offering alternative treatment options may not be appropriate at this stage when the patient is already scheduled for a modified mastectomy. It may add confusion and further anxiety.

Correct Answer: A

Rationale: Step 1: Handwashing is crucial in preventing the spread of viral conjunctivitis, which is highly contagious. Step 2: Children often touch their eyes and then surfaces, aiding in disease transmission. Step 3: Educating parents and the child on proper hand hygiene can help contain the infection. Step 4: Antibiotics are not effective against viral infections, so compliance is not necessary. Step 5: Complications like meningitis and septicemia are extremely rare with viral conjunctivitis. Step 6: Surgery is not indicated for viral conjunctivitis, as it is a self-limiting condition.

Correct Answer: A

Rationale: The correct answer is A: Disturbed body image. Enucleation can have a significant impact on a patient's self-image and self-esteem. By addressing this nursing diagnosis, the nurse can help the patient cope with the changes in their physical appearance and support them in adjusting to wearing a prosthesis. Summary: - Choice B (Chronic pain) is incorrect because enucleation may cause acute pain initially, but chronic pain is not a common concern post-enucleation. - Choice C (Ineffective protection) is incorrect because enucleation does not necessarily affect the eye's protection mechanism. - Choice D (Unilateral neglect) is incorrect as it refers to a neurological condition unrelated to the patient's situation post-enucleation.