• (A) Fatigue, lethargy
• (B) Eating disorder
• (C) Anxiety
• (D) all the above

Check AnswerSolution[D]:-All of the above are signals of stress. Fatigue and eating disorders fall into physiologic signals; anxiety and anger are psychologic signals, and restlessness is a behavioral indicator.

• (A) The term implies wholeness.
• (B) Holistic refers to the whole body, including mind and psyche.
• (C) The term parallels wellness and means if the person is holistic, they are healthy.
• (D) The term suggests that the body, mind, and spirit are one and interacts as an open system with the environment.

Check AnswerSolution[D]:-The most complete definition is to consider all aspects of a person relating as an open system.

• (A) Herbal medicine
• (B) Chiropractic
• (C) Energy medicine
• (D) Homeopathy

Check AnswerSolution[A]:-Herbal medicines are one of the most frequently used alternative treatment modes. They are much more frequently used in other parts of the world than in the United States. The other alternative practices are used, but not as frequently as herbs.

• (A) Age
• (B) Environment
• (C) Degree of flexibility of the individual
• (D) all the above

Check AnswerSolution[D]:-The only adaptation factor that does not influence how the individual adapts to stress is religion. The other factors all influence thesepatterns.

• (A) Pay attention to unimportant details.
• (B) Rank tasks to be completed in order of importance.
• (C) Consider unpleasant past events and figure out what went wrong.
• (D) Anticipate negative outcomes before they occur.

Check AnswerSolution[B]:-This is a positive suggestion for coping with stress. All of the remaininanswers are exactly the opposite of a therapeutic suggestion.

• (A) Diet is a major contributor to health or disease.
• (B) Nutrition influences how long we live.
• (C) Diet can cure disease.
• (D) The quality of food influences well-being.

Check AnswerSolution[A]:-More and more research is showing that diet/nutrition is a majorcontributor to health and the prevention of disease.

• (A) “I think that you should ask your doctor about this.”
• (B) “Perhaps it would be better to stick to mainstream medicine.”
• (C) “Let’s get your doctor and my supervisor together to discuss your question.”
• (D) “I’ll bring you information about alternative treatments.”

Check AnswerSolution[C]:-This is the most open-ended response and does not place the nursein legal jeopardy. (1) and (2) close off communication

• (A) Stress is a specific syndrome.
• (B) Stress is manifested by specific changes in the body.
• (C) Stress can only be controlled by changes in thought patterns.
• (D) Stress causes a multiplicity of changes in the body.

Check AnswerSolution[C]:-Stress can be controlled and coped with by a variety of methods,including physical activity and relaxation methods such as deep breathingand meditation, not just one, changing thought patterns. All of theother answers are correct and fit Selye’s definition of stress.

• (A) Chronic stress causes changes in the immune system.
• (B) Stressors may be chemical, physical, developmental, or emotional.
• (C) The stress syndrome can be both positive and negative.
• (D) The danger signals of stress are easy to observe.

Check AnswerSolution[D]:-Although there are many signals of stress, including physical, psychologic,and behavioral, often they are difficult to identify in the clientbecause many of them are subtle (for example, lack of interest in life, lackof concentration, irregular heartbeats). All of the other statements aboutstress are correct.

• (A) Counting to 10 before getting angry.
• (B) Sitting relaxed and quiet, clearing the mind, and breathing deeply.
• (C) Jumping up and down on a trampoline.
• (D) Saying a mantra or one word over and over again.

Check AnswerSolution[B]:-Sitting quietly, clearing the mind, and deep breathing or meditationare the best methods for destressing. The other methods listed may workfor certain individuals, but they have not proven to be as effective.

• (A) The wrong client.
• (B) The wrong medication.
• (C) The wrong dosage.
• (D) The wrong route.

Check AnswerSolution[C]:-Surveys have found that administering the wrong dose is the mostcommon cause of injury. Route is seldom erroneous, the medication usuallyvalidated, and the client identified correctly.

• (A) Consult the pharmacist.
• (B) Consult the ordering physician.
• (C) Consult the drug manufacturer.
• (D) Recheck the medication against the MAR.

Check AnswerSolution[B]:-The physician would be the authority to clarify rationale for the particularmedication’s use based on the individual client’s need/condition.

• (A) 110 mmHg.
• (B) 100 mmHg.
• (C) 95 mmHg.
• (D) 90 mmHg.

Check AnswerSolution[D]:-Systolic pressures less than 90 mm Hg may be associated withdecreased cardiac output or orthostatic hypotension.

• (A) Beads from capsules may be chewed.
• (B) Liquid from capsules can be mixed with food.
• (C) Sublingual tablets may be given to the client who isNPO.
• (D) B and C

Check AnswerSolution[D]:-Alterations for oral medication administration that are acceptableinclude mixing liquid from capsules with food and administering sublingualtablets to a client who is NPO.

• (A) Can cause systemic effects.
• (B) Cause a burning sensation.
• (C) Dilate the pupil.
• (D) Treat eye infections.

Check AnswerSolution[A]:-Rapid absorption of drops such as beta blocking agents used for glaucomacan cause serious bradycardia. Pressing the inner canthus helps preventthis adverse effect.

• (A) Upward and backward.
• (B) Downward and backward.
• (C) Upward and forward.
• (D) Downward and forward

Check AnswerSolution[A]:-For adults, upward and backward pull straightens the ear canal.

• (A) Anterior superior spine of iliac crest.
• (B) Posterior superior spine of iliac crest.
• (C) Greater trochanter.
• (D) A and B

Check AnswerSolution[D]:-The anterior superior spine of iliac crest and greater trochanter areidentified by using the nurse’s right hand for client’s left hip, or left handfor client’s right hip. The acromion process is a landmark for deltoidinjection and the posterior superior spine of iliac crest is used for dorsoglutealinjection. The gluteal fold is not a bony landmark and is not usedto identify any injection site. The upper outer quadrant of the buttocksrelates to soft tissue rather than bony landmarks, is highly variableamong clients, and is totally unreliable for predicting location of underlyingnerves and blood vessels.

• (A) The canister’s remaining contents may have expired.
• (B) The canister’s remaining contents may be activeingredient only.
• (C) The canister’s remaining contents may be propellantonly.
• (D) Clients become drug tolerant before the canisteris empty.

Check AnswerSolution[C]:-It is not uncommon for active ingredients to be depleted while propellantremains in the canister.

• (A) Add equivalent amount of air to the cloudy insulin.
• (B) Add equivalent amount of air to the clear insulin.
• (C) Withdraw the clear solution.
• (D) A B C

Check AnswerSolution[D]:-The cloudy insulin should never contact the clear insulin, as itwould cause the clear insulin remaining in the vial to lose its intendedshort action.

• (A) Site infection.
• (B) Lipodystrophy.
• (C) Insulin shock.
• (D) Ketoacidosis.

Check AnswerSolution[D]:-Pump, tubing, or needle malfunction results in failure to deliverinsulin and causes risk of diabetic ketoacidosis due to elevated bloodsugar.