Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is using an interpreter to communicate with a client who speaks a different language than the nurse.
Which of the following actions should the nurse take?
A. Avoid asking the client personal questions.
Choice A is wrong because avoiding asking the client personal questions can hinder rapport building and prevent the nurse from obtaining important information about the client’s health and needs.
B. Observe the client’s body language during the conversation.
Observe the client’s body language during the conversation. This action will help the nurse to assess the client’s nonverbal cues and emotions, which can enhance communication and understanding. The nurse should also determine the client’s understanding several times during the conversation and use lay terms if possible.
C. Maintain eye contact with the interpreter when asking questions.
Choice C is wrong because maintaining eye contact with the interpreter when asking questions can show disrespect and disinterest to the client and his family. The nurse should look at the client and his family when asking questions, not at the interpreter.
D. Include medical terminology when discussing the client’s condition.
Choice D is wrong because including medical terminology when discussing the client’s condition can confuse the client and his family and create barriers to communication. The nurse should use simple and clear language that the client and his family can understand.
This question is an excerpt from Nurse Dive's nursing test bank - ATI PN Capstone Proctored Comprehensive Assessment 2020 B. Take the full exam now
Full Explanation
Observe the client’s body language during the conversation. This action will help the nurse to assess the client’s nonverbal cues and emotions, which can enhance communication and understanding. The nurse should also determine the client’s understanding several times during the conversation and use lay terms if possible.
Choice A is wrong because avoiding asking the client personal questions can hinder rapport building and prevent the nurse from obtaining important information about the client’s health and needs.
Choice C is wrong because maintaining eye contact with the interpreter when asking questions can show disrespect and disinterest to the client and his family. The nurse should look at the client and his family when asking questions, not at the interpreter.
Choice D is wrong because including medical terminology when discussing the client’s condition can confuse the client and his family and create barriers to communication. The nurse should use simple and clear language that the client and his family can understand.
Similar Questions
A nurse on an inpatient unit is assisting with the discharge plan for a client who has schizophrenia.
Which of the following resources should the nurse include in the plan?
A. Contact information for a community mental health center.
Contact information for a community mental health center. A community mental health center can provide ongoing outpatient care and support services for a client who has schizophrenia after discharge from an inpatient unit. A community mental health center can also help the client access other resources such as medication, housing, and vocational training.
B. A list of primary prevention activities.
Choice B is wrong because a list of primary prevention activities is not relevant for a client who already has schizophrenia. Primary prevention aims to prevent the occurrence of a disease or disorder in the first place.
C. Contact information for enrollment in a 12-step program.
Choice C is wrong because contact information for enrollment in a 12-step program is not appropriate for a client who has schizophrenia unless they also have a substance use disorder. A 12-step program is a self-help group that follows a set of principles to achieve and maintain sobriety.
D. A referral for respite care services.
Choice D is wrong because a referral for respite care services is not necessary for a client who has schizophrenia unless they also have a caregiver who needs temporary relief from their caregiving duties. Respite care services provide short-term care for clients who are dependent on others for their daily needs.
Full Explanation
Contact information for a community mental health center. A community mental health center can provide ongoing outpatient care and support services for a client who has schizophrenia after discharge from an inpatient unit. A community mental health center can also help the client access other resources such as medication, housing, and vocational training.
Choice B is wrong because a list of primary prevention activities is not relevant for a client who already has schizophrenia. Primary prevention aims to prevent the occurrence of a disease or disorder in the first place.
Choice C is wrong because contact information for enrollment in a 12-step program is not appropriate for a client who has schizophrenia unless they also have a substance use disorder. A 12-step program is a self-help group that follows a set of principles to achieve and maintain sobriety.
Choice D is wrong because a referral for respite care services is not necessary for a client who has schizophrenia unless they also have a caregiver who needs temporary relief from their caregiving duties. Respite care services provide short-term care for clients who are dependent on others for their daily needs.
A nurse at a long-term care facility is caring for a client who has AIDS. The client accidentally spills the contents of their urinal on the floor.
After cleaning up the spill with soap and water, the nurse should apply a solution of water and which of the following disinfectants to the floor?
A. Isopropyl alcohol.
Choice A is wrong because isopropyl alcohol is not recommended for disinfecting environmental surfaces. It can evaporate quickly and may not have enough contact time to kill the pathogens.
B. Chlorhexidine.
Choice B is wrong because chlorhexidine is an antiseptic, not a disinfectant. It is used for skin cleansing or wound irrigation, but it is not effective against spores or non-enveloped viruses.
C. Hydrogen peroxide.
Choice C is wrong because hydrogen peroxide is a low-level disinfectant that can be inactivated by organic matter. It is not suitable for disinfecting surfaces contaminated with blood or body fluids.
D. Bleach.
According to the CDC, bleach is an effective disinfectant for environmental surfaces contaminated with blood or body fluids from a person with AIDS or other bloodborne pathogens. Bleach can kill HIV and hepatitis viruses when used in a 1:10 dilution with water.
Full Explanation
Bleach.
According to the CDC, bleach is an effective disinfectant for environmental surfaces contaminated with blood or body fluids from a person with AIDS or other bloodborne pathogens. Bleach can kill HIV and hepatitis viruses when used in a 1:10 dilution with water.
Choice A is wrong because isopropyl alcohol is not recommended for disinfecting environmental surfaces. It can evaporate quickly and may not have enough contact time to kill the pathogens.
Choice B is wrong because chlorhexidine is an antiseptic, not a disinfectant. It is used for skin cleansing or wound irrigation, but it is not effective against spores or non-enveloped viruses.
Choice C is wrong because hydrogen peroxide is a low-level disinfectant that can be inactivated by organic matter.
It is not suitable for disinfecting surfaces contaminated with blood or body fluids.
A nurse is collecting data for a client’s health history as well as physical examination.
Which of the following information should the nurse identify as a risk factor for type 2 diabetes mellitus?
A. History of exercise-induced asthma.
Choice A is wrong because history of exercise-induced asthma is not a risk factor for type 2 diabetes mellitus. Asthma is a respiratory condition that causes inflammation and narrowing of the airways, but it does not affect the metabolism of glucose or insulin.
B. Age 35 years.
Choice B is wrong because age 35 years is not a risk factor for type 2 diabetes mellitus. Although the risk of diabetes increases with age, especially after 45 years, it can also occur in younger people. Age alone is not enough to cause diabetes.
C. History of mumps.
Choice C is wrong because history of mumps is not a risk factor for type 2 diabetes mellitus. Mumps is a viral infection that affects the salivary glands, but it does not damage the pancreas or impair insulin production.
D. BMI 32.2.
A high body mass index (BMI) is a major risk factor for type 2 diabetes mellitus, as it indicates overweight or obesity.
Full Explanation
BMI 32.2.
A high body mass index (BMI) is a major risk factor for type 2 diabetes mellitus, as it indicates overweight or obesity.
Overweight or obesity can cause insulin resistance, which means the body cells do not respond well to insulin and cannot take up glucose from the blood. This leads to high blood sugar levels and diabetes.
Choice A is wrong because history of exercise-induced asthma is not a risk factor for type 2 diabetes mellitus.
Asthma is a respiratory condition that causes inflammation and narrowing of the airways, but it does not affect the metabolism of glucose or insulin.
Choice B is wrong because age 35 years is not a risk factor for type 2 diabetes mellitus.
Although the risk of diabetes increases with age, especially after 45 years, it can also occur in younger people.
Age alone is not enough to cause diabetes.
Choice C is wrong because history of mumps is not a risk factor for type 2 diabetes mellitus.
Mumps is a viral infection that affects the salivary glands, but it does not damage the pancreas or impair insulin production.
Some other risk factors for type 2 diabetes mellitus are family history, race or ethnicity, physical inactivity, prediabetes, gestational diabetes, polycystic ovarian syndrome, and smoking.