Nokea
A client is admitted to the emergency room with renal calculi. Upon assessment, which of the following findings should the nurse expect?
- A. Bradycardia
- B. Bradypnea
- C. Severe pain
- D. Nocturia
Correct Answer: C
Rationale: Severe pain (renal colic) is the most common symptom of renal calculi, caused by the stone moving and blocking the ureter.
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A nurse is admitting a client with a history of duodenal ulcer. To determine if the client's current symptoms are related to this information, the nurse should assess the client for which manifestations of a duodenal ulcer?
- A. Pain relieved by food intake
- B. Pain radiating down the right arm
- C. Nausea and vomiting
- D. Weight loss
Correct Answer: A
Rationale: Pain relief after eating is characteristic of duodenal ulcers as food neutralizes gastric acid temporarily.
A nurse is caring for a client who has just developed a pulmonary embolism. Which of the following medications should the nurse anticipate administering?
- A. Atropine
- B. Furosemide
- C. Heparin
- D. Dexamethasone
Correct Answer: C
Rationale: Heparin is an anticoagulant used in the initial treatment of pulmonary embolism to prevent further clot formation.
A nurse is obtaining a health history for a client with chronic pancreatitis. Which of the following indicates the primary cause of the client's condition?
- A. Weight gain
- B. Use of alcohol
- C. Abdominal pain relieved with food or antacids
- D. Exposure to occupational chemicals
Correct Answer: B
Rationale: The use of alcohol is the most common cause of chronic pancreatitis, accounting for about 70% of cases.
A nurse is assessing a client who sustained a basal skull fracture and notes a thin stream of clear drainage coming from the client's right nostril. Which of the following actions should the nurse take first?
- A. Test the drainage for the halo sign.
- B. Ask the client to blow his nose.
- C. Notify the physician.
- D. Suction the nostril.
Correct Answer: A
Rationale: Testing for the halo sign (glucose in drainage) helps identify CSF leakage which requires immediate intervention.
A nurse in an emergency department is planning care for a client who is having an acute myocardial infarction (MI). Which of the following medications should the nurse plan to administer after the initial acute phase to manage the client's pain and anxiety?
- A. Nitroglycerin
- B. Aspirin
- C. Oxygen
- D. Morphine
Correct Answer: D
Rationale: Morphine is used for pain/anxiety management post-MI after acute interventions.