Nokea
A client is admitted with a suspected pulmonary embolism. Which of the following diagnostic tests should the nurse anticipate being ordered?
- A. Chest X-ray.
- B. D-dimer blood test.
- C. Echocardiogram.
- D. Arterial blood gas analysis.
Correct Answer: B
Rationale: D-dimer is a specific test to detect blood clots, highly sensitive for pulmonary embolism
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A middle-aged female client begins outpatient therapy sessions with a psychiatric clinical nurse specialist for management of a phobic disorder. Which of the following nursing interventions should be an initial approach in symptom reduction?
- A. Referral for psychopharmacologic intervention.
- B. Group psychotherapy.
- C. Systematic desensitization.
- D. Biofeedback.
Correct Answer: C
Rationale: phobic disorders are learned responses; learned responses can be unlearned through certain techniques, such as behavioral modification; systematic desensitization is a form of behavior modification; is a strategy used in conjunction with deep muscle relaxation to decrease the extreme response to anxiety-producing situations as they are gradually exposed; then exposure is increased; goal is to eradicate the phobic response by replacing it with the relaxation response
An older man is seen in the outpatient clinic for treatment of an acute attack of gout.
- A. Which nursing intervention is most beneficial for decreasing pain during ambulation in a client with gout?
- B. Perform passive range-of-motion exercises before walking.
- C. Encourage partial weight bearing while ambulating.
- D. Immobilize the extremity between activities.
- E. Restrict the amount of time and the distance the man walks.
Correct Answer: B
Rationale: Partial weight bearing reduces pressure and stress on the affected joint, alleviating gout-related pain during ambulation. Passive exercises may worsen pain, immobilization increases stiffness, and restricting walking does not address pain management during necessary movement.
A nurse discusses changes due to aging with a group at the senior citizen center. The nurse knows that which of the following changes in the pattern of urinary elimination normally occur with aging?
- A. Decreased frequency.
- B. Incontinence.
- C. Sphincter reflexes decrease.
- D. Formation of bladder stones.
Correct Answer: B
Rationale: ureters, bladder, and urethra lose muscle tone results in stress and urge incontinence
At approximately 6 PM, the nurse begins to open the nurses' notes for the evening shift. The last entry is noted for 1 PM, and there is no signature. The MOST appropriate nursing response is to
- A. leave approximately three or four lines for the day nurse to enter the day information and sign the chart.
- B. review with the client the activities after 1 PM, and enter what are determined to be the activities after 1 PM.
- C. begin charting on the next line below the last entry, and make a note for the day nurse to make a late entry to complete the chart.
- D. do not enter anything until the day nurse has been notified of the problem and returns to the unit to complete charting.
Correct Answer: C
Rationale: day nurse can make a 'late entry' to add any additional information
A client has an order for furosemide (Lasix) 40 mg IV push via a heparin lock. Which of the following nursing actions would be MOST appropriate?
- A. Use a 16- to 18-gauge 1-in needle for administration.
- B. Administer the medication over one to two minutes.
- C. One cc of 1:1,000 heparin flush should be administered before the medication.
- D. A primary IV should be started prior to medication administration.
Correct Answer: B
Rationale: furosemide (Lasix) given IV push should be administered slowly over one to two minutes