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A client is admitted to the hospital after sustaining a fall from a roof. The client has multiple lacerations and a right leg fracture, which has been treated with a plaster cast. How should the nurse position the client's leg to promote optimal circulation?
- A. Flat or a level position
- B. Flat for 3 hours and elevated for 1 hour
- C. Elevated for 3 hours, and then flat for 1 hour
- D. Elevated on pillows continuously for 24 to 48 hours
Correct Answer: D
Rationale: A casted extremity is elevated continuously for the first 24 to 48 hours to minimize swelling and promote venous drainage. The other options are not part of standard positioning of the newly casted extremity.
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A client with a history of heart failure is prescribed losartan (Cozaar). The nurse should monitor the client for which of the following side effects?
- A. Hyperkalemia.
- B. Hypoglycemia.
- C. Weight gain.
- D. Hypertension.
Correct Answer: A
Rationale: Losartan, an ARB, can cause hyperkalemia, requiring monitoring of potassium levels.
A nurse is preparing to administer 500 mL of an I.V. solution to a child over 12 hours via tubing that delivers microdrips at 60 gtt/mL. At what rate should the nurse infuse the solution?
- A. 42 gtt/minute.
- B. 83 gtt/minute.
- C. 60 gtt/minute.
- D. 21 gtt/minute.
Correct Answer: A
Rationale: Calculate: 500 mL over 12 hours = 41.67 mL/hour. For microdrip (60 gtt/mL), 41.67 mL/hour ×60 gtt/mL = 2500 gtt/hour ÷ 60 minutes = 41.67 gtt/minute, rounded to 42 gtt/minute.
You are a registered nurse who is performing the role of a case manager in your hospital. You have been asked to present a class to newly employed nurses about your role, your responsibilities and how they can collaborate with you as the case manager. Which of the following is a primary case management responsibility associated with reimbursement that you should include in this class?
- A. The case manager's role in terms of organization wide performance improvement activities
- B. The case manager's role in terms complete, timely and accurate documentation
- C. The case manager's role in terms of the clients' being at the appropriate level of care
- D. The case manager's role in terms of contesting denied reimbursements
Correct Answer: C
Rationale: A primary case management responsibility related to reimbursement is ensuring that clients are at the appropriate level of care , which directly impacts reimbursement by ensuring services match medical necessity and payer requirements.
The nurse is teaching a client with a new diagnosis of hypertension about the DASH diet. Which of the following foods should the nurse recommend?
- A. White bread.
- B. Bananas.
- C. Sausage.
- D. Potato chips.
Correct Answer: B
Rationale: Bananas are rich in potassium and part of the DASH diet, which promotes heart-healthy eating to manage hypertension.
The nurse notes that the primary health care provider has written a prescription for prednisone for a client. The nurse contacts the primary health care provider about revision of the client's medication plan if which medication is noted on the client's medication record?
- A. Furosemide
- B. Oxycodone
- C. Acetaminophen
- D. Acetylsalicylic acid
Correct Answer: D
Rationale: Prednisone, a glucocorticoid, is irritating to the gastrointestinal (GI) tract, which could be worsened by the use of other products that have the same side effect. Therefore, products such as aspirin (acetylsalicylic acid) and nonsteroidal antiinflammatory drugs are not used during corticosteroid therapy.