Nokea
A client has increasing pain in both hands. On examination, the nurse notes that the metacarpophalangeal and proximal interphalangeal joints are enlarged and swollen, swanneck deformity is evident, and the fingers on both hands show ulnar deviation. These findings are consistent with which of the following disorders?
- A. Osteoarthritis
- B. Rheumatoid arthritis
- C. Gouty arthritis
- D. Psoriatic arthritis
Correct Answer: B
Rationale: Swanneck deformity, ulnar deviation, and swollen MCP/PIP joints are classic for rheumatoid arthritis (B). Osteoarthritis (A) affects distal joints, gout (C) causes tophi, and psoriatic arthritis (D) involves skin lesions.
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Following eruption of the primary teeth, the mother can promote chewing by giving the toddler:
- A. Pieces of hot dog
- B. Carrot sticks
- C. Pieces of cereal
- D. Raisins
Correct Answer: C
Rationale: Cereal pieces are soft, safe, and promote chewing without the choking risk posed by hot dogs, carrots, or sticky raisins in toddlers.
The nurse is at the nurses' station charting when a physician comes up and says, 'Since you are already logged into the computer, I need you to look up some labs on a client.' The client is not cared for by this nurse. Which response by the nurse is most appropriate?
- A. Let me check that for you in a moment.
- B. Why don't you call the lab? That will be quicker.
- C. That is not my client, but I will get his nurse for you.
- D. I can't do that because of HIPAA, but I will let the charge nurse look it up.
Correct Answer: D
Rationale: Accessing a client's lab results without authorization violates HIPAA, as the nurse is not assigned to the client. The charge nurse can ensure proper access.
The nurse observes a LPN/LVN perform a wet-to-dry dressing change on a 2-inch abdominal incision. Which of the following behaviors, if performed by the LPN/LVN, would indicate an understanding of proper technique?
- A. A clean cotton ball is used to cleanse from the top of the incision to the bottom of the incision using long strokes.
- B. The incision is packed with sterile gauze, and then sterile saline is poured over the dressing.
- C. The nurse packs wet gauze into the incision without overlapping it onto the skin.
- D. The old dressing is saturated with sterile saline before it is removed.
Correct Answer: C
Rationale: if wet dressing touches skin it could cause skin breakdown
The charge nurse considers both patient-related and staff-related factors when making daily assignments. All of the following are patient-related factors EXCEPT
- A. mechanical ventilation use.
- B. complex medication regimen.
- C. isolation precaution requirements.
- D. nurse-to-client ratio.
Correct Answer: D
Rationale: Nurse-to-client ratio is a staff-related factor, affecting workload distribution. Ventilation, medications, and isolation are patient-specific needs.
The nurse is assessing a client at home who is receiving outpatient hemodialysis 12 hours a week. The nurse knows the client needs further instruction about proper diet when he states which of the following?
- A. I drink prune juice when I'm constipated.
- B. I drink ginger ale with lunch.
- C. I drink 1 cup of milk with my dinner.
- D. My bread choice is white rather than whole grain.
Correct Answer: C
Rationale: Milk is high in phosphorus and potassium, which should be limited in hemodialysis patients to prevent electrolyte imbalances.