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The nurse is caring for a client with heart failure who develops a persistent, dry cough after starting enalapril. Which of the following new prescriptions would the nurse anticipate for this client?
- A. Alprazolam
- B. Guaifenesin
- C. Lisinopril
- D. Valsartan
Correct Answer: D
Rationale: A dry cough is a common side effect of ACE inhibitors like enalapril, so switching to an ARB like valsartan (D) is anticipated. Alprazolam (A), guaifenesin (B), and lisinopril (C, another ACE inhibitor) are inappropriate.
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A woman is pregnant for the first time and is Rh negative. Her husband is Rh positive. She tells the nurse that he is very worried about her baby. Which information should the nurse plan to include when talking with this woman?
- A. The first baby should not be affected.
- B. She will need to get treatment after the second baby is born.
- C. There is nothing that can be done to prevent the baby from developing erythroblastosis fetalis, but it can be treated.
- D. She can have intrauterine transfusion for the first baby if blood levels indicate that the child is affected.
Correct Answer: A
Rationale: The first Rh-positive baby is typically unaffected as maternal antibodies develop post-delivery. RhoGAM is given after birth to prevent issues in future pregnancies, not after the second baby.
The nurse is reinforcing skin care guidelines for a client who is receiving external radiation therapy. Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I will apply an ice pack to the treatment site if my skin begins to burn.
- B. I will rub baby oil on the site after each treatment to prevent dry skin.
- C. I will use extra measures to protect my skin from sun exposure.
- D. I will wash the treatment site with lukewarm water and mild soap.
- E. I will wear soft, loose-fitting clothing.
Correct Answer: C,D,E
Rationale: Sun protection (C), gentle washing (D), and loose clothing (E) are correct for radiation therapy skin care. Ice packs (A) can damage skin, and baby oil (B) may irritate or trap radiation.
A nurse is collecting data on a 58-year-old client with blurred vision and reduced visual fields. The nurse finds which manifestation most concerning?
- A. Difficulty adjusting to dimmed lights
- B. Extreme eye pain
- C. Gradual loss of peripheral vision
- D. Opaque appearance of lens
Correct Answer: B
Rationale: Extreme eye pain (B) suggests acute conditions like glaucoma, requiring urgent attention. Difficulty in dim light (A), peripheral vision loss (C), and cataracts (D) are less acute.
Which teaching instructions should the nurse reinforce to a client with advanced chronic obstructive pulmonary disease?
- A. Follow a low-calorie diet
- B. Obtain a pneumococcal vaccine
- C. Report increased sputum
- D. Take iron to improve anemia
- E. Use an incentive spirometer
Correct Answer: B,C,E
Rationale: Pneumococcal vaccine (B), reporting increased sputum (C), and incentive spirometry (E) manage COPD. A high-calorie diet, not low-calorie (A), is needed. Iron (D) is only indicated for confirmed anemia.
A nurse on an orthopedic unit is caring for four clients with a casted extremity. Which client does the nurse prioritize to see first?
- A. Client reporting a tingling sensation
- B. Client reporting itching under the cast
- C. Client reporting pain of 5/10 on movement
- D. Client reporting throbbing on dependent positioning
Correct Answer: A
Rationale: Tingling (A) suggests neurovascular compromise, requiring urgent assessment. Itching (B), moderate pain (C), and throbbing (D) are less critical.