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A client admitted to the medical nursing unit has classic symptoms of tuberculosis (TB) and tests positive on the purified protein derivative (PPD) skin test. Several months later, the nurse who cared for the client also tests positive on an annual TB skin test for work. The most likely course of treatment if the chest X-ray (CXR) is negative is to:
- A. repeat a TB skin test in six months.
- B. treat the nurse with an anti-infective agent for six months.
- C. monitor for signs and symptoms within the next year.
- D. follow up in one year at the next annual physical with CXR only.
Correct Answer: B
Rationale: Exposure with a positive TB skin test usually requires six months of prophylactic treatment unless contraindicated.
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An effective intervention for a client diagnosed with Obsessive-Compulsive Disorder is:
- A. discussing the repetitive action
- B. insisting the client not perform the repetitive act
- C. informing the client that the act is not necessary
- D. encouraging daily exercise
Correct Answer: D
Rationale: Exercise reduces anxiety and redirects attention in OCD, serving as a non-confrontational intervention to decrease compulsive behaviors.
Social support systems include of the following except:
- A. call-in help lines.
- B. emotional assistance provided by others.
- C. community support groups.
- D. use of coping skills and verbalization for anger management.
Correct Answer: D
Rationale: Use of coping skills and verbalization for anger management are personal strategies, not examples of social support systems. Choices 1, 2, and 3 are all social support systems.
Which of the following blood pressure parameters indicates PIH? Elevation over a baseline of:
- A. 30 mmHg systolic and/or 15 mmHg diastolic.
- B. 40 mmHg systolic and/or 20 mmHg diastolic.
- C. 10 mmHg systolic and/or 5 mmHg diastolic.
- D. 20 mmHg systolic and/or 20 mmHg diastolic.
Correct Answer: A
Rationale: These are the accepted parameters for mild PIH. Mild preclampsia includes an increase in systolic blood pressure higher than 30 mmHg or an increase in diastolic blood pressure higher than 15 mmHg, noted on two readings taken 6 hours apart (or 140/90).
When assessing a client in the Emergency Department whose membranes have ruptured, the nurse notes that the fluid is a greenish color. What is the cause of this greenish coloration?
- A. blood
- B. meconium
- C. hydramnios
- D. caput
Correct Answer: B
Rationale: Greenish amniotic fluid passed when the fetus is in a cephalic (head) presentation might indicate fetal distress. A fetus in the breech presentation passes meconium due to compression on the intestinal tract.
A client receiving preoperative instructions asks questions repeatedly about when to stop eating the night before the procedure. The nurse tries to refocus the client. The nurse notes that the client is frequently startled by noises in the hall. Assessment reveals rapid speech, trembling hands, tachypnea, tachycardia, and elevated blood pressure. The client admits to feeling nervous and having trouble sleeping. Based on the assessment, the nurse documents that the client has:
- A. mild anxiety.
- B. moderate anxiety.
- C. severe anxiety.
- D. a panic attack.
Correct Answer: C
Rationale: In severe anxiety, a client focuses on small or scattered details. The person is unable to solve problems. With mild anxiety, stimuli are readily perceived and processed, and the ability to learn and solve problems is enhanced. Moderate anxiety narrows the perceptual field, but the client notices things brought to his attention. During a panic attack, the person is disorganized and might be hyperactive or unable to speak or act.