UMAK NC1 Funda 1

A 47-year-old man with stage II colon cancer refuses chemotherapy, saying, “My pastor told me healing comes from prayer, not poison.” His wife is crying and begs the nurse to convince him to start chemo. The oncologist has explained prognosis, but the client remains firm. As the assigned nurse, what is the most appropriate initial action?

• Explore the client’s spiritual beliefs and assess how these influence his treatment choices

• Document the client’s refusal and advise the wife to continue persuading him

• Notify the physician immediately that the client is non-compliant

• Provide printed educational materials that explain chemotherapy’s benefits

A 20-year-old female college student reports frequent headaches and stomach pain before examinations. She denies any medical illness and maintains a healthy diet. However, she admits that her parents demand high grades and she fears disappointing them. Which factor most strongly contributes to her illness behavior?

• Psychological factor: stress and anxiety related to academic pressure

• Biological factor: hereditary predisposition to migraines

• Social factor: peer competition in the university environment

• Cultural factor: dietary habits affecting gastrointestinal health

A 54-year-old bus driver with a 30-pack-year smoking history and sedentary lifestyle presents for a routine check-up. His BP is 130/84 mmHg, BMI 32, fasting blood sugar 125 mg/dL. He denies symptoms and insists he is “still strong.” How should the nurse classify his health status?

• At risk, because multiple modifiable factors (obesity, smoking, sedentary lifestyle) predispose him to chronic illness

• Ill, because elevated blood pressure and glucose automatically mean disease

• Healthy, because absence of symptoms indicates no current illness

• Disabled, because obesity and smoking limit his functional abilities

A nursing student preparing for the NLE reports difficulty sleeping, palpitations, and diarrhea the week before the exam. She continues to review despite exhaustion and says, “I have to push harder or I’ll fail.” Which interpretation is most accurate?

• The student is experiencing stress-related symptoms due to academic pressure.

• The student is physically ill and should seek medical attention.

• The student is overconfident and does not need to study more.

• The student is managing her time effectively.

A 72-year-old retired teacher says, “I look back at my life and I am proud of what I accomplished, even if I made mistakes.” According to Erikson’s stages of psychosocial development, this reflects successful completion of which stage?

• Ego integrity vs. despair, because the client demonstrates acceptance of life lived

• Generativity vs. stagnation, because he contributes to the next generation

• Identity vs. role confusion, because he maintains a clear sense of self

• Intimacy vs. isolation, because he values close personal relationships

A 32-year-old client with chronic pain often requests early administration of analgesics, becomes angry when asked to wait, and accuses the nurse of “not caring.” The nurse feels frustrated but knows that maintaining professionalism is important. What is the best nursing action in this situation?

• Reflect on personal feelings to prevent them from interfering with professional care

• Explain firmly that the physician’s orders cannot be changed

• Avoid this client whenever possible to prevent conflict

• Tell the client honestly about feeling irritated with his behavior

A 45-year-old newly diagnosed diabetic is learning insulin self-administration. He watches carefully but says, “I’ll just let my wife do it, I’m afraid of needles.” The nurse knows independence is critical for long-term control. What should the nurse do first?

• Encourage the client to practice with supervision to build confidence

• Allow the wife to give injections since the client is unwilling

• Provide only written instructions for the client to review

• Delay teaching until the client is discharged home

A nurse forgot to chart a wound dressing change done at 9 AM. At 3 PM, she remembers. What is the correct documentation?

• Write a late entry noting the dressing change performed at 9 AM

• Record it as if it were done at 3 PM for consistency

• Omit the entry since care was already provided

• Write a note to the physician instead of documenting in the chart

A 70-year-old client with hearing loss frequently answers inappropriately during teaching. Which is the most therapeutic strategy for the nurse?

• Face the client directly and speak slowly in a low-pitched tone

• Shout louder so the client can hear better

• Write all information and avoid verbal interaction

• Ask family members to interpret and explain for the client

A nurse assigned to a terminally ill client begins sharing her own story of losing a loved one in detail, causing the client to cry more. What boundary is being crossed?

• Nurse is shifting focus from the client to herself, breaching therapeutic use of self

• Nurse is providing empathy through appropriate self-disclosure

• Nurse is practicing therapeutic communication

• Nurse is encouraging ventilation of feelings