Nokea
A client reports recent exposure to hepatitis A. What is a common mode of transmission for this virus?
- A. Blood transfusion
- B. Fecal-oral route
- C. Needle sharing
- D. Sexual contact
Correct Answer: B
Rationale: The correct answer is B: Fecal-oral route. Hepatitis A is commonly transmitted through ingestion of contaminated food or water. The virus is present in the feces of infected individuals and can be spread through inadequate sanitation practices. Blood transfusion (A) is not a common mode of transmission for hepatitis A. Needle sharing (C) is more associated with hepatitis B and C transmission. Sexual contact (D) is not a primary mode of transmission for hepatitis A. In summary, the fecal-oral route is the most common mode of transmission for hepatitis A due to contamination of food or water with the virus.
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During a home visit, the nurse should evaluate the adequacy of a client's COPD treatment by assessing for which primary symptom?
- A. Dyspnea
- B. Tachycardia
- C. Unilateral diminished breath sounds
- D. Edema of the ankles
Correct Answer: A
Rationale: The correct answer is A: Dyspnea. Dyspnea is a primary symptom of COPD due to impaired airflow. Assessing dyspnea helps determine the effectiveness of COPD treatment. Tachycardia (B) may occur but is not a primary symptom. Unilateral diminished breath sounds (C) suggest other conditions, not COPD. Edema of the ankles (D) is more indicative of heart failure.
A 65-year-old female client arrives in the emergency department with shortness of breath and chest pain. The nurse accidentally administers 10 mg of morphine sulfate instead of the prescribed 4 mg. Later, the client's respiratory rate is 10 breaths/minute, oxygen saturation is 98%, and she states her pain has subsided. What is the legal status of the nurse?
- A. The nurse is guilty of negligence and will be sued.
- B. The client would not be able to prove malpractice in court.
- C. The nurse is protected by the Good Samaritan Act.
- D. The healthcare provider should have given the morphine sulfate dose.
Correct Answer: B
Rationale: The correct answer is B: The client would not be able to prove malpractice in court. In this scenario, although the nurse made an error in administering a higher dose of morphine, the client's condition improved, as evidenced by stable vital signs and pain relief. Therefore, there was no harm caused to the client due to the mistake. In malpractice cases, the client needs to prove that harm or injury resulted from the healthcare provider's actions. Since the client's condition improved, it would be difficult to establish malpractice in this situation.
Choice A is incorrect because negligence requires harm or injury to occur, which is not the case here. Choice C is incorrect as the Good Samaritan Act typically applies to individuals providing emergency care in good faith at the scene of an emergency, not within a healthcare setting. Choice D is incorrect as the focus is on the nurse's error in administering the incorrect dose, not on the healthcare provider's responsibility in this context.
A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). Which laboratory value indicates a therapeutic effect of the medication?
- A. INR of 2.5.
- B. PTT of 45 seconds.
- C. Hemoglobin of 12 g/dL.
- D. Platelet count of 150,000/mm³.
Correct Answer: A
Rationale: The correct answer is A: INR of 2.5. INR (International Normalized Ratio) is used to monitor the effectiveness of warfarin therapy. A target INR range for DVT treatment is typically 2.0-3.0. An INR of 2.5 indicates that the client's blood is clotting within the desired therapeutic range, preventing excessive clotting while avoiding excessive bleeding.
B: PTT measures the effectiveness of heparin, not warfarin.
C: Hemoglobin level and D: Platelet count are not specific indicators of warfarin's therapeutic effect on clotting factors.
In summary, the correct answer A is the most relevant laboratory value for monitoring the therapeutic effect of warfarin in a client with DVT.
A client with a newly created ileostomy has not had ostomy output for the past 12 hours and reports worsening nausea. What is the nurse's priority action?
- A. Facilitate a referral to the wound-ostomy-continence (WOC) nurse
- B. Report signs and symptoms of obstruction to the health care provider
- C. Encourage the client to mobilize to enhance mobility
- D. Contact the health care provider to obtain a swab of the stoma for culture
Correct Answer: B
Rationale: The correct answer is B: Report signs and symptoms of obstruction to the health care provider. The priority action in this scenario is to address the possibility of an obstruction, which could be a life-threatening complication. Reporting to the healthcare provider allows for prompt assessment and intervention to prevent further complications. A: Referring to the WOC nurse may be necessary but is not the priority when obstruction is suspected. C: Encouraging mobilization is important for overall health but not the priority in this urgent situation. D: Obtaining a swab for culture is not the priority when obstruction is suspected.
A 45-year-old woman presents with fatigue, weight gain, and constipation. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
Correct Answer: A
Rationale: The most likely diagnosis is A: Hypothyroidism. High TSH and low free T4 levels indicate primary hypothyroidism. Elevated TSH is a compensatory response by the pituitary gland to stimulate the thyroid to produce more thyroid hormones, but the thyroid gland is unable to do so effectively, resulting in low free T4 levels. Fatigue, weight gain, and constipation are classic symptoms of hypothyroidism.
- B: Hyperthyroidism is characterized by low TSH and high free T4 levels, opposite of the lab results presented.
- C: Thyroiditis may initially present with high or low thyroid hormone levels, but the combination of high TSH and low free T4 levels is more indicative of hypothyroidism.
- D: Thyroid cancer typically does not cause abnormal thyroid hormone levels; it is more commonly associated with thyroid nodules or masses.