Nokea
A client is admitted with a diagnosis of myxedema. An initial assessment of the client would reveal the symptoms of:
- A. Slow pulse, weight loss, diarrhea, and cardiac failure
- B. Weight gain, lethargy, slowed speech, and decreased respiratory rate
- C. Rapid pulse, constipation, and bulging eyes
- D. Decreased body temperature, weight loss, and increased respiratory rate
Correct Answer: B
Rationale: Myxedema (severe hypothyroidism) causes weight gain, lethargy, slowed speech, and decreased respiratory rate due to slowed metabolism. Other options describe hyperthyroidism or mixed symptoms.
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The nurse is caring for a client with Ménière's disease. The nurse stands directly in front of the client when speaking. Which of the following BEST describes the rationale for the nurse's position?
- A. This enables the client to read the nurse's lips.
- B. The client does not have to turn her head to see the nurse.
- C. The nurse will have the client's undivided attention.
- D. There is a decrease in client's peripheral visual field.
Correct Answer: B
Rationale: by decreasing movement of client's head, vertigo attacks may be decreased
The nurse returns to the nurse's station after making client rounds and finds four phone messages.
Which of the following messages should the nurse return FIRST?
- A. A client with hepatitis A who states, 'My arms and legs are itching.'
- B. A client with a cast on the right leg who states, 'I have a funny feeling in my right leg.'
- C. A client with osteomyelitis of the spine who states, 'I am so nauseous that I can't eat.'
- D. A client with arthritis who states, 'I am having trouble sleeping at night.'
Correct Answer: B
Rationale: Strategy: Eliminate the most stable clients. (1) caused by accumulation of bile salts under the skin; treat with calamine lotion and antihistamines (2) correct-may indicate neurovascular compromise; requires immediate assessment (3) requires follow-up but not highest priority (4) requires assessment but not the highest priority
The nurse is caring for a client with a history of anxiety who is receiving lorazepam (Ativan) 0.5 mg PO tid. Which of the following client statements would be of GREATest concern to the nurse?
- A. I feel drowsy in the morning.
- B. I have a dry mouth.
- C. I feel dizzy when I stand up.
- D. I take my medication with food.
Correct Answer: C
Rationale: Dizziness upon standing suggests orthostatic hypotension, a serious side effect of lorazepam, increasing fall risk and requiring evaluation. Options A, B, and D are less concerning: drowsiness and dry mouth are common, and taking with food is acceptable.
A client is scheduled to undergo a bone marrow aspiration. Which position would the nurse assist the client into for this procedure?
- A. Dorsal recumbent
- B. Supine
- C. High Fowler's
- D. Lithotomy
Correct Answer: A
Rationale: The dorsal recumbent position is used for bone marrow aspiration, typically performed on the iliac crest, allowing access and patient comfort. Supine, High Fowler's, and lithotomy positions are not suitable, so B, C, and D are incorrect.
A 52-year-old woman has an appendectomy for a ruptured appendix. The nurse observes a student nurse perform a wet-to-dry dressing change on the 2-in incision.
Which of the following behaviors, if performed by the student nurse, would require an intervention by the nurse?
- A. The old dressing is saturated with sterile saline before it is removed.
- B. Dry dressings are placed over the saline-saturated gauze in the incision.
- C. Wound debris and necrotic tissue are removed with the old dressing.
- D. The gauze is saturated with sterile saline before it is packed into the incision.
Correct Answer: A
Rationale: Strategy: 'Require an intervention' indicates an incorrect action. (1) correct-should be removed dry so wound debris and necrotic tissue are removed with old dressing (2) done to protect clothing and bedding (3) purpose of wet-to-dry dressing (4) appropriate procedure