Nokea
A client is diagnosed with emphysema and cor pulmonale. Which findings are characteristic of cor pulmonale?
- A. Hypoxia, shortness of breath, and exertional fatigue
- B. Weight loss, increased RBC, and fever
- C. Rales, edema, and enlarged spleen
- D. Edema of the lower extremities and distended neck veins
Correct Answer: D
Rationale: Cor pulmonale, right heart failure from lung disease, causes lower extremity edema and distended neck veins due to increased venous pressure. Hypoxia and fatigue are general emphysema symptoms.
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The client is admitted with a diagnosis of preterm labor. Which fetal monitoring technique is most appropriate?
- A. Non-stress test
- B. Biophysical profile
- C. Both A and B
- D. Neither A nor B
Correct Answer: C
Rationale: Preterm labor requires fetal monitoring to assess well-being. Non-stress tests evaluate fetal heart rate and biophysical profiles assess multiple parameters (e.g. movement amniotic fluid). Both are appropriate.
The nurse is caring for a client with a diagnosis of hyperemesis gravidarum. Which laboratory finding is most likely to be present?
- A. Metabolic alkalosis
- B. Hyponatremia
- C. Hypokalemia
- D. All of the above
Correct Answer: D
Rationale: Hyperemesis gravidarum causes prolonged vomiting leading to metabolic alkalosis (loss of stomach acid) hyponatremia (electrolyte loss) and hypokalemia (potassium loss). All are likely findings in severe cases.
A 6-year-old girl is visiting the outpatient clinic because she has a fever and a rash. The doctor diagnoses chickenpox. Her mother asks the nurse how many baby aspirins her daughter can have for fever. The nurse should:
- A. Advise the mother not to give her aspirin
- B. Ask if the client is allergic to aspirin before giving further information
- C. Assess the function of the client's cranial nerve VIII
- D. Check the aspirin bottle label to determine milligrams per tablet
Correct Answer: A
Rationale: Aspirin taken during a viral infection has been implicated as a predisposing factor to Reye's syndrome in children and adolescents. Children and adolescents should not be given aspirin. Allergy to aspirin is not related to Reye's syndrome. Tinnitus, caused by damage to the acoustic nerve, occurs with aspirin toxicity, but this is not related to Reye's syndrome. A 6-year-old child should not be given any baby aspirin.
The nurse is caring for a client with a history of atrial fibrillation. Which medication is most likely to be prescribed to prevent thromboembolism?
- A. Warfarin (Coumadin)
- B. Aspirin
- C. Clopidogrel (Plavix)
- D. Heparin
Correct Answer: A
Rationale: Warfarin is commonly prescribed for atrial fibrillation to prevent thromboembolism by maintaining anticoagulation (target INR 2–3). Aspirin and clopidogrel are less effective, and heparin is used short-term.
A nurse indicates that she is licensed in her new state of residence even though reciprocity has not been granted. The nurse’s action can result in a charge of:
- A. Fraud
- B. Tort
- C. Malpractice
- D. Negligence
Correct Answer: A
Rationale: Claiming licensure without reciprocity is a deliberate misrepresentation, constituting fraud. A tort is a civil wrong, malpractice involves substandard care, and negligence implies carelessness, none of which fully describe this intentional act.