A nurse is caring for a client who had abdominal surgery 24 hr ago. Which of the following actions is the
nurse's priority? - ✔✔Assist with deep breathing and coughing
A nurse is talking with a client who has stage IV breast cancer. The nurse should recognize which of the
following statements by the client as a constructive use of a defense mechanism? - ✔✔"I told my doctor
that I would like to start a support group for other women who are sick in my community"
A nurse is caring for a client who has immunosuppression and a continuous IV infusion. Which of the
following actions should the nurse take? - ✔✔Monitor the client's mouth every 8 hr
A nurse is caring for a 2 month old infant who has Hirschsprung disease (HD). Which of the following
areas should the nurse assess for manifestations of HD? - ✔✔C
The nurse should assess the infant's abdomen for distention and visible peristalsis, which are
manifestations of HD
A nurse at a mental health clinic is caring for four clients. The nurse should recognize the following
clients is using dissociation as a defense mechanism? - ✔✔A client who was abused as a child describes
the abuse as if it happened to someone else
A nurse is providing teaching to a client who has a new diagnosis of type 1 diabetes mellitus. The nurse
should instruct the client to monitor for which of the following findings as a manifestation of
hypoglycemia? - ✔✔irritability
A nurse in an outpatient mental health clinic is caring for four clients. The nurse should recognize that
which of the following clients is effectively using sublimation as a defense mechanism? - ✔✔A client
who channels their energy into a new hobby following the loss of their job
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