Nokea
A 10-year-old client with rheumatic fever is on bed rest. Which of the following would be an appropriate diversional activity for the nurse to encourage?
- A. Watching television with his roommate.
- B. Coloring picture books with his brother.
- C. Keeping up with his school work.
- D. Building a bird house.
Correct Answer: B
Rationale: Coloring is a quiet, bed-appropriate activity that engages a 10-year-old without physical exertion, suitable for rheumatic fever recovery.
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A client diagnosed with valvular heart disease is at risk for developing heart failure. What should the nurse assess as the priority when monitoring for heart failure?
- A. Heart rate
- B. Breath sounds
- C. Blood pressure
- D. Activity tolerance
Correct Answer: B
Rationale: Breath sounds are the best way to assess for the onset of heart failure. The presence of crackles or an increase in crackles is an indicator of fluid in the lungs caused by heart failure. The remaining options are components of the assessment but are less reliable indicators of heart failure.
Which is an intrinsic risk factor that places the client at risk for pressure ulcers?
- A. Pressure
- B. Shearing
- C. Impaired tissue perfusion
- D. Friction
Correct Answer: C
Rationale: Impaired tissue perfusion is an intrinsic risk factor for pressure ulcers, as it reduces oxygen and nutrient delivery to tissues, increasing susceptibility to breakdown.
A client has been prescribed metoprolol for hypertension. The nurse monitors client compliance carefully because of which common side effect of the medication?
- A. Impotence
- B. Mood swings
- C. Increased appetite
- D. Complete atrioventricular (AV) block
Correct Answer: A
Rationale: A common side effect of beta-adrenergic blocking agents, such as metoprolol, is impotence. Other common side effects include fatigue and weakness. Central nervous system side effects occur rarely and include mental status changes, nervousness, depression, and insomnia. Mood swings, increased appetite, and complete AV block are not reported side effects.
A client is a 43-year-old G2 P1 at 16 weeks' gestation that has completed prenatal testing for chromosomal abnormalities. The results reveal the infant is a female with Down syndrome. The nurse should tell the parents which of the following? Check all that apply.
- A. Down syndrome can occur in mothers of any age.
- B. Down syndrome is correlated with autosomal dominant traits carried by the parents.
- C. Down syndrome is a result of autosomal recessive traits carried by the parents.
- D. Down syndrome depends upon maternal prenatal care since pregnancy began.
- E. Down syndrome occurs more frequently with advanced maternal age.
- F. Down syndrome results from a trisomy of chromosome 21.
Correct Answer: A,E,F
Rationale: Down syndrome can occur at any maternal age, is more frequent with advanced maternal age, and results from trisomy 21. It is not related to dominant/recessive traits or prenatal care.
A client 6 weeks postpartum is asking the nurse about taking progesterone (Depo-Provera) for birth control. Which of the following should the nurse determine? Select all that apply.
- A. If the client has a sexually transmitted disease.
- B. How willing her husband is to have her take the drug.
- C. If the woman is experiencing postpartum depression.
- D. That the woman is not currently pregnant.
- E. If the woman is breast-feeding.
Correct Answer: C,D,E
Rationale: The nurse should assess for postpartum depression, pregnancy status, and breast-feeding, as these affect Depo-Provera's safety and efficacy. STDs and husband's willingness are not primary concerns.