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NO.1 A 10-year-old client with a pin in the right femur is immobilized in traction. He is exhibiting
behavioral changes including restlessness, difficulty with problem solving, inability to concentrate on
activities, and monotony. Which of the following nursing implementations would be most effective in
helping him cope with immobility?
A. Allowing him to do as much for himself as he is able, including learning to do pin-site care under
supervision
B. Providing him with books, challenging puzzles, and games as diversionary activities
C. Having a volunteer come in to sit with the client and to read him stories
D. Stimulating rest and relaxation by gentle rubbing with lotion and changing the client's position
frequently
Answer: A
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Explanation:
(A) These activities could be frustrating for the client if he is having difficulty with problem solving
and concentration. (B) Selfcare is usually well received by the child, and it is one of the most useful
interventions to help the child cope with immobility. (C) This may be helpful to the client if he has no
visitors, but it does little to help him develop coping skills. (D) This will helpto prevent skin irritation
or breakdown related to immobility but will not help to prevent behavioral changes related to
immobility.
NO.2 A client is now pregnant for the second time. Her first child weighed 4536 g at delivery. The
client's glucose tolerance test shows elevated blood sugar levels. Because she only shows signs of
diabetes when she is pregnant, she is classified as having:
A. Gestational diabetes mellitus
B. Insulin-dependent diabetes
C. Type I diabetes mellitus
D. Type II diabetes mellitus
Answer: A
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Explanation:
(A) Insulin-dependent diabetes mellitus, also known as type I diabetes, usually appears before the
age of 30 years with an abrupt onset of symptoms requiring insulin for management. It is not related
to onset during pregnancy. (B) Non-insulin-dependent diabetes (type II diabetes) usually appears in
older adults. It has a slow onset and progression of symptoms. (C) This type of diabetes is the same as
insulin-dependent diabetes. (D) Gestational diabetes mellitus has its onset of symptoms during
pregnancy and usually disappears after delivery. These symptoms are usually mild and not life
threatening, although they are associated with increased fetal morbidity and other fetal
complications.