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The home health nurse is reinforcing teaching for a client with atrial fibrillation who is prescribed digoxin 0.25 mg orally on even-numbered days. Which client statement will require further teaching about digoxin?
- A. I will call the health care provider if I don't feel like eating.
- B. I will call the health care provider if I feel dizzy and lightheaded.
- C. I will call the health care provider if I have trouble reading.
- D. I will take my blood pressure before taking my medicine.
Correct Answer: D
Rationale: Taking blood pressure (D) is unrelated to digoxin monitoring. Anorexia (A Anorexia (A), dizziness (B), and visual changes (C) are signs of digoxin toxicity, requiring provider notification.
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The intensive care nurse is caring for a client who has just been extubated. Which interventions are appropriate at this time?
- A. Administer prescribed oral narcotics for throat pain
- B. Administer warmed, humidified oxygen via facemask
- C. Give the client ice chips to moisten the mouth
- D. Provide mouth care with oral sponges
- E. Start the client on incentive spirometer
Correct Answer: B,C,D,E
Rationale: Post-extubation, warmed, humidified oxygen (B) prevents mucosal drying, ice chips (C) moisten the mouth, oral sponges (D) maintain hygiene, and incentive spirometry (E) promotes lung expansion. Oral narcotics (A) are risky due to potential airway compromise.
Because the client has hypothyroidism, the nurse expects which of the following to be present in the client?
- A. Weight loss
- B. Respiratory rate of 30/minute
- C. Temperature of 96.8°F
- D. Scanty menses
Correct Answer: C
Rationale: Hypothyroidism slows metabolism, causing hypothermia (e.g., 96.8°F). Weight gain, not loss, slow respirations, and heavy menses are typical.
The nurse is teaching a client newly diagnosed with asthma how to use the metered-dose inhaler (MDI). The client asks when they will know the canister is empty. The best response is
- A. Drop the canister in water to observe floating
- B. Estimate how many doses are usually in the canister
- C. Count the number of doses as the inhaler is used
- D. Shake the canister to detect any fluid movement
Correct Answer: A
Rationale: Dropping the canister into a bowl of water assesses the amount of medication remaining in a metered-dose inhaler. The client should obtain a refill when the inhaler rises to the surface and begins to tip over.
The nurse observes a client who is walking with a cane. Which observation indicates that the client is walking appropriately?
- A. The client holds the cane on the affected side and moves it forward with the affected leg.
- B. The client holds the cane on the affected side and moves it forward with the unaffected leg.
- C. The client holds the cane on the unaffected side and moves it forward with the affected leg.
- D. The client holds the cane on the unaffected side and moves it forward with the unaffected leg.
Correct Answer: C
Rationale: Holding the cane on the unaffected side and moving it with the affected leg provides optimal support and balance, coordinating strength with the weaker side.
While caring for the client during the first hour after delivery, the nurse determines that the uterus is boggy and there is vaginal bleeding. What should be the nurse's first action?
- A. Check vital signs
- B. Massage the fundus
- C. Offer a bedpan
- D. Check for perineal lacerations
Correct Answer: B
Rationale: Massage the fundus. The nurse's first action should be to massage the fundus until it is firm, as uterine atony is the primary cause of bleeding in the first hour after delivery.