Nokea
A 22-year-old pregnant client is diagnosed with autoimmune hemolytic anemia. The nurse anticipates immediate treatment with
- A. IgA.
- B. IgG.
- C. IgE.
- D. IgD.
- E. None
Correct Answer: E
Rationale: Autoimmune hemolytic anemia in pregnancy is typically treated with corticosteroids or IVIG (containing IgG), but IgG alone isn’t administered. None of the options are correct.
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A client with prostate cancer has been given the option of various treatments and asks the nurse for advice. Which of the following is the most appropriate response?
- A. Let's discuss the different options and how you feel about them.'
- B. I can't help you to make a treatment decision about your treatment.'
- C. You need to discuss this decision with your physician.'
- D. I would choose surgery if I were in your position.'
Correct Answer: A
Rationale: Discussing options and feelings (A) supports the client's decision-making without giving direct advice. Other responses (B, C, D) dismiss the client's request or overstep the nurse's role.
The nurse is assisting a client with diverticulosis to select appropriate foods. Which food should be avoided?
- A. Bran
- B. Fresh peaches
- C. Cucumber salad
- D. Yeast rolls
Correct Answer: C
Rationale: Cucumber salad contains seeds and roughage, which can irritate the colon in diverticulosis and should be avoided.
An elderly client with an abdominal surgery is admitted to the unit following surgery. In anticipation of complications of anesthesia and narcotic administration, the nurse should:
- A. Administer oxygen via nasal cannula
- B. Have narcan (naloxane) available
- C. Prepare to administer blood products
- D. Prepare to do cardioresuscitation
Correct Answer: B
Rationale: Narcan reverses opioid overdose, a potential complication of narcotic use post-surgery.
A pediatric client with burns to the hands and arms has dressing changes with Sulfamylon (mafenide acetate) cream. The nurse is aware that the medication:
- A. Will cause dark staining of the surrounding skin
- B. Produces a cooling sensation when applied
- C. Can alter the function of the thyroid
- D. Produces a burning sensation when applied
Correct Answer: D
Rationale: Sulfamylon (mafenide acetate) causes a burning sensation upon application, which should be explained to the client.
The nurse is performing discharge teaching to the parents of a 7-year-old who has been diagnosed with asthma. Which sports activity would be most appropriate for this client?
- A. Baseball
- B. Swimming
- C. Football
- D. Track
Correct Answer: B
Rationale: Swimming is ideal for asthma clients as it promotes controlled breathing in a warm, humid environment, reducing the risk of exercise-induced bronchospasm.