B (6/10)
A nurse on an inpatient mental health unit is monitoring a visit between a client who
has a history of aggressive behavior and the client's partner. Which of the following
observations should the nurse identify as an indication for potential violence?
a. The client is taking numerous deep, measured breaths
b. The client is calmly telling their partner that "the staff here is so controlling"
c. The client is sitting with their head in their hands and appears to be crying
d. The client is pacing around the chair in which their partner is sitting - ANSd. The
client is pacing around the chair in which their partner is sitting
(2) indicate the a client is at risk for violent behavior - ANShyperactivity, pacing
the nurse should attempt to de-escalate a potentially violent situation by speaking to
the client in a (2) voice using: - ANScalm, low, short sentences
the client is taking numerous deep, measured breaths (is/is not) a risk for potential
violence - ANSis not
the client is calmly telling their partner that "the staff here is so controlling" (is/is not)
a risk for potential violence - ANSis not
the client is sitting with their head in their hands and appears to be crying (is/is not) a
risk for potential violence - ANSis not
the client is pacing around the chair in which their partner is sitting (is/is not) a risk
for potential violence - ANSis
A nurse is providing education to the parent of a school-age child who has asthma.
Which of the following statements by the parent indicates an understanding of the
teaching?
a. I will administer aspirin to my child to treat pain or fever
b. I will record an average of three readings from my child's peak expiratory flow
meter
c. I will place carpet in my child's bedroom to control allergens
d. I will make sure my child receives a yearly influenza immunization - ANSd. I will
make sure my child receives a yearly influenza immunization
, children who have ___ are sensitive to aspirin - ANSasthma
children who have asthma are sensitive to ___ - ANSaspirin
because it is associated with the development of ___, the nurse should teach the
parent to avoid administration of aspirin to children - ANSReye syndrome
because it is associated with the development of Reye syndrome, the nurse should
teach the parent to avoid administration of ___ to children - ANSaspirin
the parent of the child with asthma should record the (average/highest) of the three
readings when recording their child's results from the peak expiratory flow meter -
ANShighest
___ is an offending environmental irritant to a child who has asthma, which can
trigger an attack - ANScarpet
the nurse should educate the parent of the child with asthma about
(installing/removing) carpeting from the child's bedroom - ANSremoving
A nurse is providing discharge instructions about newborn care to a client who is
postpartum. Which of the following statements indicates to the nurse that the client
understands the teaching?
a. I will breastfeed my baby on a schedule of every 4 hours
b. I will bathe my baby daily
c. I will place my baby on her stomach for sleeping
d. I will cover my baby's body when I wash her hair
e. I will use the bulb syringe first in her mouth and then in her nose - ANSd. I will
cover my baby's body when I wash her hair e. I will use the bulb syringe first in her
mouth and then in her nose
the client should respond to the newborn's cues for feeding at least ___ in a 24-hr
period - ANS8-12 times
newborns eat around ___ in a 24-hr period - ANS8-12 times
the client should bathe the newborn every ___ and cleanse the face and diaper area
daily - ANS2-3 days
the client should bathe the newborn every 2-3 days and cleanse the face and diaper
area ___ - ANSdaily