Question

40.a nurse is assisting with the admission of a client to an inpatient unit. which of the following sources of information should the nurse use as a primary source of accurate data about the client?
a. client concerns
b. family information
c. medical history
d. progress note
41.a nurse in a dialysis center is caring for a client who has a new diagnosis of end - stage renal disease. at the first dialysis treatment, the client tells the nurse, \i decided to come today, but i am not sure if i will need to come back again this week. i am feeling much better since my discharge from the hospital and i think my kidneys are working again.\ the nurse should recognize the client is demonstrating which stage of kübler - rosss stages of grieving?
a. bargaining
b. denial
c. depression
d. anger
42.a nurse is caring for a client who has a new diagnosis of chronic renal failure. the nurse should recognize which of the following client statements as an indication of anticipatory grief?
a. \i know that i will get a kidney transplant. i am a good candidate.\
b. \i can now eat whatever i want. it will be dialyzed out of my system.\
c. \i just cant believe that my whole life is going to be ruined by dialysis.\
d. \i know that renal failure runs in my family and i can prevent it.\
43.a nurse is collecting data about a clients pulmonary system. while auscultating the clients lungs, the nurse hears continuous gurgling, low - pitched sounds over the trachea and bronchi. which of the following terms should the nurse use to document this finding?
a. rhonchi
b. crackles
c. wheezing
d. friction rub

Explanation:

• Question 40: The client themselves is the primary source of accurate data. Client concerns directly come from the client. Family information (B) is secondary. Medical history (C) and progress note (D) are records, not the primary source from the client at admission.
• Question 41: Denial in Kübler - Ross's stages is when a person refuses to accept the reality. The client says kidneys are working again (denying end - stage renal disease need for dialysis). Bargaining (A) is trying to make deals (e.g., "if I do X, then Y"). Depression (C) is a sense of hopelessness. Anger (D) is directed at self or others.
• Question 42: Anticipatory grief is grief before an expected loss. The statement "my whole life is going to be ruined by dialysis" (C) shows grief about the future impact of chronic renal failure. Option A is about a positive view (transplant), B is a wrong understanding (diet), D is a wrong belief (prevention).
• Question 43: Rhonchi are continuous, gurgling, low - pitched sounds heard over trachea and bronchi. Crackles (B) are discontinuous, popping sounds. Wheezing (C) is high - pitched. Friction rub (D) is a rough, grating sound.

Answer:

1. A. Client concerns
2. B. Denial
3. C. "I just can't believe that my whole life is going to be ruined by dialysis."
4. A. Rhonchi