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The spouse of a client with Alzheimer's disease expresses concern about the burden of caregiving. Which of the following actions by the nurse should be a priority?
- A. Link the caregiver with a support group
- B. Ask friends to visit regularly
- C. Schedule a home visit each week
- D. Request anti-anxiety prescriptions
Correct Answer: A
Rationale: Assisting caregivers to locate and join support groups is most helpful. Families share feelings and learn about services such as respite care. Health education is also available through local and national Alzheimer's chapters.
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The nurse is monitoring a client who is in active labor with a cervical dilation of 6 cm. Which finding requires intervention by the nurse?
- A. Contraction duration of 95 seconds
- B. Contraction frequency of every 3 minutes
- C. Contraction intensity of 45 mm Hg
- D. Uterine resting tone of 10 mm Hg
Correct Answer: A
Rationale: Contraction duration of 95 seconds (A) is too long and may reduce fetal oxygenation, requiring intervention. Frequency (B), intensity (C), and resting tone (D) are within normal limits.
The client with COPD may lose weight despite having adequate caloric intake. When counseling the client in ways to maintain an optimal weight, the nurse should tell the client to:
- A. Continue the same caloric intake and decrease his activity level
- B. Increase his activity level to stimulate his appetite
- C. Increase the amount of complex carbohydrates and decrease the amount of fat intake
- D. Decrease the amount of complex carbohydrates while increasing calories, protein, fat, vitamins, and minerals
Correct Answer: D
Rationale: Clients with COPD often have increased metabolic demands and may lose weight. To maintain optimal weight, they should increase overall caloric intake, including protein, fat, vitamins, and minerals, while possibly decreasing complex carbohydrates to balance the diet. Answer A is incorrect as decreasing activity is not beneficial. Answer B may not be feasible due to respiratory limitations. Answer C does not address the need for increased calories and nutrients.
A nurse is reinforcing fall-prevention teaching to the spouse of a 78-year-old client who recently experienced a stroke. What suggestion by the nurse is most effective in preventing falls?
- A. Ensure that your spouse rises slowly after sitting or lying down.'
- B. Purchase a walker for your spouse to use when walking around the home'
- C. Remove all area rugs and install grab bars in the bathroom'
- D. Schedule a home health aide to monitor your spouse while you are away.'
Correct Answer: C
Rationale: Removing rugs and installing grab bars (C) directly addresses environmental hazards, the most effective fall prevention strategy. Rising slowly (A), using a walker (B), or hiring an aide (D) are helpful but less comprehensive.
All of the following clients assigned to LPN/LVN ring their call bells. Which client needs the most immediate attention?
- A. A 72-year-old diabetic who is blind says she has to go to the bathroom.
- B. A 75-year-old client who has rheumatoid arthritis asks for pain medication.
- C. A client who has a blood transfusion running says her chest hurts.
- D. A postoperative client says he is in pain and wants a pain shot.
Correct Answer: C
Rationale: Chest pain during a blood transfusion suggests a possible transfusion reaction, a life-threatening emergency requiring immediate intervention. Bathroom needs, arthritis pain, or postoperative pain are less urgent.
A client is admitted with Parkinson's disease. The client has been taking Carbidopa/levodopa (Sinemet) for 1 year. Which clinical manifestation would be the most important to report?
- A. Dry mouth
- B. Spasmodic eye winking
- C. Dark urine
- D. Dizziness
Correct Answer: B
Rationale: Spasmodic eye winking could indicate a toxicity or overdose and should be reported to the physician. Other signs of toxicity include involuntary twitching of muscles, facial grimaces, and severe tongue protrusion. Answers A, C, and D are incorrect because they are side effects of the drug.