Nokea
A client has a diagnosis of discoid lupus erythematosus (DLE). The nurse recognizes that discoid lupus differs from systemic lupus erythematosus because it:
- A. Produces changes in the kidneys
- B. Is confined to changes in the skin
- C. Results in damage to the heart and lungs
- D. Affects both joints and muscles
Correct Answer: B
Rationale: Discoid lupus erythematosus primarily affects the skin, causing chronic rashes, unlike systemic lupus, which can involve multiple organs.
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A client with a right lobectomy is being transported from the intensive care unit to a medical unit. The nurse understands that the client's chest drainage system:
- A. Can be disconnected from suction if the chest tube is clamped
- B. Can be disconnected from suction, but the chest tube should remain unclamped
- C. Must remain connected by means of a portable suction
- D. Must be kept even with the client's shoulders during the transport
Correct Answer: B
Rationale: The chest tube should remain unclamped and disconnected from suction during transport to prevent tension pneumothorax, with the system kept below chest level.
A nurse assessing a client charts his blood pressure as 134/86. The pulse pressure would be
- A. 48
- B. 86
- C. 220
- D. 96
Correct Answer: A
Rationale: Pulse pressure is calculated as systolic BP minus diastolic BP: 134 - 86 = 48 mmHg.
The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
- A. Visual disturbances, including diplopia
- B. Ascending paralysis and loss of motor function
- C. Cogwheel rigidity and loss of coordination
- D. Progressive weakness that is worse at the day's end
Correct Answer: D
Rationale: Myasthenia gravis is characterized by muscle weakness that worsens with activity and improves with rest, typically more pronounced at the end of the day.
An adolescent primigravida who is 10 weeks pregnant attends the antepartal clinic for a first check-up. To develop a teaching plan, the nurse should initially assess:
- A. The client's knowledge of the signs of preterm labor
- B. The client's feelings about the pregnancy
- C. Whether the client was using a method of birth control
- D. The client's thought about future children
Correct Answer: B
Rationale: Assessing the client's feelings about the pregnancy is critical at 10 weeks to tailor education and support to her emotional needs.
A client admitted for treatment of a deep venous thrombosis of the calf complains of dyspnea and chest pain. What is the best response by the nurse?
- A. administer oxygen at 2 L/min as ordered prn
- B. place client in a semi-Fowler's position
- C. prepare client for diagnostic tests
- D. obtain vital signs
Correct Answer: C
Rationale: Dyspnea and chest pain suggest a possible pulmonary embolism, a complication of DVT, requiring immediate preparation for diagnostic tests to confirm and treat.