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A nurse is providing teaching to a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will take my medication with food to increase absorption.
- B. If my heart starts racing
- C. my provider might need to adjust my dosage.
- D. I will stop taking this medication once I feel better.
- E. I should take this medication at night before bed.
Correct Answer: B
Rationale: The correct answer is B because it indicates the client understands the potential side effect of levothyroxine, which is palpitations or a racing heart. This shows awareness of the need to monitor and report adverse effects to the healthcare provider promptly. Taking the medication with food (A) actually decreases its absorption. Dosage adjustments (C) are common in thyroid medication but don't necessarily demonstrate immediate understanding. Stopping the medication once feeling better (D) is incorrect as levothyroxine is usually a lifelong treatment. Taking medication at night (E) is not crucial for levothyroxine as long as it is taken consistently.
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A nurse is assessing a clients ECG strip and notes an irregular heart rate of 98/min with no clear P waves. Which of the following cardiac dysrhythmias should the nurse document?
- A. Sinus bradycardia
- B. Atrial fibrillation
- C. Ventricular tachycardia
- D. First-degree heart block
Correct Answer: B
Rationale: The correct answer is B: Atrial fibrillation. In atrial fibrillation, the heart rate is irregular and fast (98/min), and there are no clear P waves on the ECG strip, which aligns with the findings in the scenario. Atrial fibrillation is characterized by chaotic electrical activity in the atria, leading to an irregular heart rate. Sinus bradycardia (A) is characterized by a slow heart rate with normal P waves. Ventricular tachycardia (C) is a fast heart rhythm originating in the ventricles with distinct QRS complexes. First-degree heart block (D) is identified by a prolonged PR interval but should still have clear P waves. Other choices are not relevant. In this case, the absence of clear P waves and irregular heart rate point towards atrial fibrillation as the correct dysrhythmia to document.
A nurse is providing discharge teaching about infection control at home for a client who has tuberculosis. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will place my used tissues in a plastic bag.
- B. I will share my utensils with my family.
- C. I will not need to wear a mask at home.
- D. I will stop taking my medications when I feel better.
Correct Answer: A
Rationale: The correct answer is A: "I will place my used tissues in a plastic bag." This statement indicates understanding of infection control for tuberculosis by properly disposing of contaminated materials to prevent the spread of the disease. Placing used tissues in a plastic bag helps contain the bacteria.
Choices B, C, and D are incorrect:
B: Sharing utensils can spread the infection to family members.
C: Not wearing a mask at home can expose others to the bacteria.
D: Stopping medications prematurely can lead to treatment failure and drug resistance.
A nurse is caring for a client who has multiple leg fractures and is 24 hr postoperative following placement of skeletal traction. Which of the following actions should the nurse take?
- A. Inspect the pin sites at least every 8 hr.
- B. Apply direct pressure to pin sites.
- C. Remove traction weights for comfort.
- D. Encourage vigorous movement of the affected limb.
Correct Answer: A
Rationale: Correct Answer: A. Inspect the pin sites at least every 8 hr.
Rationale:
1. Inspecting pin sites regularly is crucial to monitor for signs of infection or other complications.
2. Postoperative clients with skeletal traction are at high risk for pin site infections.
3. Regular inspection allows early detection and intervention to prevent complications.
4. Waiting longer than every 8 hours may lead to delayed identification of issues.
Summary:
B. Applying direct pressure is contraindicated as it can cause harm.
C. Removing traction weights without medical order can lead to complications.
D. Encouraging vigorous movement is inappropriate and can cause harm.
A nurse is inspecting the skin of a client who has basal cell carcinoma. The nurse should identify which of the following lesion characteristics on the clients skin?
- A. A pearly, waxy nodule
- B. A scaly, red patch
- C. A dark, irregular mole
- D. A firm, painless lump
Correct Answer: A
Rationale: The correct answer is A: A pearly, waxy nodule. Basal cell carcinoma typically presents as a pearly, waxy nodule on the skin. This characteristic appearance is due to the growth of abnormal cells in the basal cell layer of the skin. The nodule may also have small blood vessels visible on its surface. This presentation is distinct from other skin lesions. Choice B, a scaly red patch, is more indicative of conditions like psoriasis or eczema. Choice C, a dark irregular mole, is more suggestive of melanoma. Choice D, a firm, painless lump, is more characteristic of conditions like lipomas or fibromas. Thus, the correct answer is A based on the specific characteristics of basal cell carcinoma.
An emergency room nurse is assessing a client who has asthma and difficulty breathing. Which of the following findings should indicate to the nurse that the client is experiencing status asthmaticus?
- A. Mild wheezing
- B. Use of accessory muscles
- C. Decreased respiratory rate
- D. Productive cough
Correct Answer: B
Rationale: The correct answer is B: Use of accessory muscles. In status asthmaticus, a severe and life-threatening asthma exacerbation, the client's airways are severely constricted, leading to inadequate air exchange. The use of accessory muscles (such as intercostal and supraclavicular muscles) indicates significant respiratory distress as the body tries to compensate for the difficulty in breathing. Mild wheezing (choice A) may be present in asthma but does not necessarily indicate status asthmaticus. Decreased respiratory rate (choice C) is not consistent with the increased respiratory effort seen in status asthmaticus. Productive cough (choice D) is more indicative of conditions such as bronchitis or pneumonia, not necessarily status asthmaticus.