The use of clichés in therapeutic communication is commonly construed by the client as the nurse’s lack of

understanding, involvement, and caring, so the client might feel demeaned and discounted. Psychosocial Integrity

Genital herpes can be transmitted by oral, genital, and anal sex. The other statements are myths. Safety and

Infection Control

Start a fast weight-loss diet. Health Promotion and Maintenance

Only an unbound drug can be distributed to active receptor sites. Therefore, the more of a drug that is bound

to protein, the less it is available for the desired drug effect. Choice 1 is incorrect because less drug is available if

it is bound to protein. Choice 2 is incorrect because distribution to receptor sites is irrelevant if the drug, which is

bound to protein, cannot bind with a receptor site. Choice 4 is incorrect because metabolism is not increased. The

liver first has to remove the drug from the protein molecule before metabolism can occur. The protein is then free

to return to circulation and be used again. Pharmacological Therapies

Hepatitis A does not produce a carrier state. It is transmitted via contaminated water or food via the oral-fecal route and is not blood borne. Safety and Infection Control

Even before the physical assessment (which might or might not be indicated at the time of administration of Vancomycin), ensuring that the client is not allergic to the medication is the most critical action the nurse must take before administering any drug. Lab values regarding renal functioning and therapeutic ranges via peaks and troughs are also important with some medications such as Vancomycin because renal damage can occur if blood drug levels remain high over time. Safety and Infection Control

Choice 3 is indicative of a tension pneumothorax, which is considered a medical emergency. The respiratory system is severely compromised and venous return to the heart is affected. The mediastinal shift is to the unaffected side. Choice 1 contains symptoms of pleurisy, and Choice 2 lists symptoms of bronchitis. Neither are emergencies. The client in Choice 4 should expect difficulty breathing after exercise when asthma is an existing condition and might need immediate attention if his rescue inhaler is ineffective. Physiological Adaptation

Restating allows the client to validate the nurse’s understanding of what has been communicated. It’s an active listening technique. Regarding Choice 2, judgments should be suspended in a nurse-client relationship. Choice 3 is incorrect because leading questions ask for more information rather than showing understanding. Choice 4 communicates understanding, but the client has no way of measuring the understanding. Psychosocial Integrity

All physical and psychosocial therapies can be used concurrently with drugs and other modalities to manage pain. These interventions can be carried out by the nurse with the client and family. Basic Care and Comfort

Pernicious anemia is a megaloblastic, macrocytic, normochronic anemia caused by a deficiency of the intrinsic factor produced by the stomach. This results in malabsorption of vitamin B12, which is necessary for DNA synthesis and maturation of RBC. Education should include side effects of Vitamin B12, which can include pain and burning at the injection site, peripheral vascular thrombosis, and transient diarrhea. Physiological Adaptation

Normal serum potassium levels fall in a range of 3.5–5.5mEq/L. The other choices listed fall below or above this range. Reduction of Risk Potential

When performing a parancentesis, the client must be sitting up to allow the fluid to settle to the lower abdomen. To prevent trauma to the bladder while inserting a needle to aspirate the fluid, the bladder must be empty. Basic Care and Comfort

Padding distributes pressure so that bony prominences do not receive the brunt of pressure when a client pulls against the restraints. Pressure, especially over bony prominences, causes tissue damage due to ischemia. Safety and Infection Control

Elder adults might be more at risk for gastric and renal toxicity, increasing among elder adults. Basic Care

and Comfort

The client cannot speak to alert the nurse to his pain state. The nurse needs to provide alternate methods of communication with the client. Basic Care and Comfort