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A client has a routine Papanicolaou (Pap) test during a yearly gynecologic examination. The result reveals a class V finding. What should the nurse tell the client about this finding?
- A. It’s normal and requires no action
- B. It calls for a repeat Pap test in 6 weeks
- C. It calls for a repeat Pap test in 3 months
- D. It calls for a biopsy as soon as possible
Correct Answer: D
Rationale: The correct answer is D because a class V Pap test finding indicates severe abnormalities, such as high-grade dysplasia or carcinoma in situ. Therefore, the nurse should instruct the client to undergo a biopsy as soon as possible to confirm the diagnosis and initiate appropriate treatment promptly. Choices A, B, and C are incorrect because a class V result is not normal and requires immediate follow-up, rather than waiting or repeating the Pap test at a later time.
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Just as the nurse was entering the room, the patient who was sitting on his chair begins to have a seizure. Which of the following must the nurse do first?
- A. Ease the patient to the floor
- B. Insert a padded tongue depressor between his jaws
- C. Lift the patient and put him on the bed
- D. Restraint patient’s body movement
Correct Answer: A
Rationale: The correct answer is A: Ease the patient to the floor. This is the first step because it helps prevent injury during a seizure. Lowering the patient to the floor prevents falls and protects the patient's head. Choices B, C, and D are incorrect. Choice B can cause injury or obstruct the airway, choice C involves unnecessary movement, and choice D can lead to further harm or injury. It is crucial to prioritize safety and prevent harm during a seizure episode.
The nurse is caring for a client with thrombocytopenia. What is the best way to protect this client?
- A. Limit visits by family members
- B. Encourage the client to use a wheelchair
- C. Use the smallest needle possible for injections
- D. Maintain accurate fluid intake and output records Situation: AIDS cases has been all over the country and yet only few are reported cases due to the stigma attach to it.
Correct Answer: C
Rationale: The correct answer is C: Use the smallest needle possible for injections. In a client with thrombocytopenia (low platelet count), there is an increased risk of bleeding and bruising. Using the smallest needle possible for injections reduces the risk of causing injury to blood vessels and tissues, minimizing bleeding complications. Limiting visits by family members (choice A) is not directly related to protecting the client's safety. Encouraging wheelchair use (choice B) is not necessary unless indicated for mobility reasons. Maintaining accurate fluid intake and output records (choice D) is important for overall client care but does not directly address the risk of bleeding in thrombocytopenia.
A client is admitted to the ICU, which laboratory result must be reported immediately to the physician?
- A. Hematocrit 48%
- B. paCO2 38 mm Hg
- C. platelets 18,000
- D. WBC count 8000
Correct Answer: C
Rationale: The correct answer is C: platelets 18,000. A critically low platelet count can lead to life-threatening bleeding in the ICU. Normal platelet count ranges from 150,000 to 450,000. A count of 18,000 indicates severe thrombocytopenia. Immediate reporting is crucial for prompt intervention.
Rationale for why other choices are incorrect:
A: Hematocrit of 48% is within normal range (male: 42-52%, female: 37-47%).
B: paCO2 of 38 mm Hg is within normal range (35-45 mm Hg).
D: WBC count of 8000 is within normal range (4000-11000/uL).
In critical care settings, it is vital to prioritize and address life-threatening conditions promptly, hence the urgent need to report the critically low platelet count.
A client receives a sealed radiation implant to treat cervical cancer. When caring for this client, the nurse should:
- A. Consider the client’s urine, feces, and vomitus to be highly radioactive
- B. Consider the client to be radioactive for 10 days after implant removal
- C. Allow soiled linens to remain in the room until after the client is discharged
- D. Maintain the client on complete bed rest with bathroom privileges only
Correct Answer: A
Rationale: The correct answer is A because bodily fluids and excretions (urine, feces, vomitus) can become contaminated with radiation from the implant. Therefore, they should be considered highly radioactive and handled appropriately.
Choice B is incorrect because the client may remain radioactive for a longer period than 10 days post-implant removal.
Choice C is incorrect because soiled linens should be handled according to radiation safety protocols and removed promptly.
Choice D is incorrect because bed rest is not necessary unless specifically indicated by the healthcare provider; the client should be encouraged to move around as tolerated to prevent complications.
Which antiparkinsonian drug is associated with the on-off phenomenon and the wearing-off effect?
- A. Amantadine
- B. Levodopa
- C. Benztropine
- D. Pramixole
Correct Answer: B
Rationale: The correct answer is B: Levodopa. Levodopa is associated with the on-off phenomenon and wearing-off effect in Parkinson's disease treatment due to fluctuations in its effectiveness over time. The on-off phenomenon refers to sudden and unpredictable changes in motor function, while wearing-off effect occurs when the medication's effects diminish before the next dose. Amantadine (A) is not typically associated with these phenomena. Benztropine (C) is an anticholinergic used for tremors and rigidity. Pramixole (D) is a dopamine agonist that can cause dyskinesias but is not primarily linked to on-off or wearing-off effects.