Nokea
A client is taking Deltasone (prednisone) each morning to treat his systemic lupus erythematosus. Which statement best explains the reason for taking the prednisone in the morning?
- A. There is less chance of forgetting the medication if taken in the morning.
- B. There will be less fluid retention if taken in the morning.
- C. The medication is absorbed best with the breakfast meal.
- D. Morning administration mimics the body's natural secretion of corticosteroid.
Correct Answer: D
Rationale: Prednisone is taken in the morning to mimic the body’s natural cortisol peak, which occurs early in the day, minimizing adrenal suppression and side effects. Timing does not primarily affect forgetting, fluid retention, or absorption.
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The nurse is preparing to collect a sputum specimen from the client suspected of having tuberculosis. What is the correct method for obtaining a sputum specimen?
- A. Collect the specimen in the morning prior to breakfast.
- B. Collect the specimen on three consecutive days.
- C. Transport the collected specimen to the laboratory immediately.
- D. Offer mouth care after collecting the sputum specimen.
- E. Allow the client to rinse his mouth with an antiseptic solution prior to the sputum collection.
Correct Answer: A, B, C, D
Rationale: Morning collection (A) yieldsthough sputum is most concentrated. Three consecutive days (B) ensure reliable tuberculosis diagnosis. Immediate transport (C) prevents degradation. Mouth care (D) maintains hygiene. Antiseptic rinse (E) may kill bacteria, invalidating the sample.
A client is being discharged from the hospital today. The discharge teaching for care of her colostomy included which of the following basic principles for protecting the skin around her stoma:
- A. Taping a pouch that is leaking
- B. Cutting the skin barrier 1 1/2 inches larger than the stoma
- C. Changing the pouch only when leakage occurs
- D. Using a skin sealant under pouch adhesives
Correct Answer: D
Rationale: When skin sealant is used under the tape, the outermost layer of the epidermis remains intact. When no skin sealant is used, this layer is removed when the tape is removed.
A female client decides on hemodialysis. She has an internal vascular access device placed. To ensure patency of the device, the nurse must:
- A. Assess the site for leakage of blood or fluids
- B. Auscultate the site for a bruit
- C. Assess the site for bruising or hematoma
- D. Inspect the site for color, warmth, and sensation
Correct Answer: B
Rationale: This is an internal device. Assessment of the site should include assessing for swelling, pain, warmth, and discoloration. This measure does not assess patency. The presence of a bruit indicates good blood flow through the device. The nurse should inspect the site for bruising or hematoma; however, this measure does not assure patency of the device. The nurse should inspect the vascular access site frequently for signs of infection. However, this does not assure patency.
A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant twice before; the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the gravida and para system to record the client's obstetrical history, the nurse should record:
- A. Gravida 3 para 1
- B. Gravida 3 para 2
- C. Gravida 2 para 1
- D. Gravida 2 para 2
Correct Answer: B
Rationale: Gravida=3 (current pregnancy), Para=2 (two births after 20 weeks).
A 40-year-old client is admitted to the hospital for tests to diagnose cancer. Since his admission, he has become dependent and demanding to the nursing staff. The nurse identifies this behavior as which defense mechanism?
- A. Denial
- B. Displacement
- C. Regression
- D. Projection
Correct Answer: C
Rationale: Regression involves reverting to an earlier developmental stage, such as dependency, in response to stress like a cancer diagnosis.