Nokea
A client scheduled for a cardiac catheterization tells the nurse, 'My mother died during this same procedure 10 years ago. I'm afraid the same thing will happen to me.' Which of the following responses by the nurse is the most appropriate?
- A. It's normal to be scared. You are safe here. Let's discuss the procedure.
- B. I'll ask the cardiologist to come and speak with you about your concerns.
- C. We have the best outcomes of any facility in the area for this procedure.
- D. Don't worry. The procedure has improved a lot in the last 10 years.
Correct Answer: A
Rationale: Acknowledging the client’s fear and discussing the procedure provides reassurance and addresses concerns therapeutically.
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A 19-year-old female comes into the women's clinic for an STD test. The nurse explains all of the following confirmed cases of STDs must be reported to the Centers for Disease Control (CDC) EXCEPT
- A. genital herpes.
- B. chlamydia.
- C. hepatitis B.
- D. gonorrhea.
Correct Answer: A
Rationale: Chlamydia, gonorrhea, and hepatitis B are reportable to the CDC. Genital herpes is not nationally reportable, though local regulations may vary.
The nurse is assessing a client with a closed reduction of a fractured femur. Which finding should the nurse report to the physician?
- A. Chest pain and shortness of breath.
- B. Ecchymosis on the side of the injured leg.
- C. Oral temperature of 99.2°F.
- D. Complaints of level two pain on a scale of five.
Correct Answer: A
Rationale: Chest pain and shortness of breath may indicate a pulmonary embolism, a serious complication requiring immediate reporting.
A 23-year-old woman at 32-weeks gestation is seen in the outpatient clinic. Which of the following findings, if assessed by the nurse, would indicate a possible complication?
- A. The client’s urine test is positive for glucose and acetone.
- B. The client has 1+ pedal edema in both feet at the end of the day.
- C. The client complains of an increase in vaginal discharge.
- D. The client says she feels pressure against her diaphragm when the baby moves.
Correct Answer: A
Rationale: abnormal finding, could indicate gestational diabetes (GDM), hazard of placental insufficiency
Prior to drawing blood for blood gas analysis, the nurse conducts the modified Allen test to ensure there is adequate collateral circulation. The nurse asks the client to extend the wrist over a rolled towel and make a fist. Place the following steps (Roman numerals) in order from first to last.
- A. Ask the client to open and close the hand until the skin blanches.
- B. Palpate the ulnar and radial pulses and apply pressure to both arteries.
- C. Observe the hand for color.
- D. Release the ulnar artery while maintaining pressure on the radial artery.
Correct Answer: A,B,D,C
Rationale: Modified Allen test sequence: Blanch hand (I), compress arteries (II), release ulnar artery (IV), observe color return (III) to confirm collateral circulation.
Cystic fibrosis is an exocrine disorder that affects several systems of the body. The earliest sign associated with a diagnosis of cystic fibrosis is:
- A. Steatorrhea
- B. Frequent respiratory infections
- C. Increased sweating
- D. Meconium ileus
Correct Answer: D
Rationale: Meconium ileus, a bowel obstruction at birth, is often the earliest sign of cystic fibrosis in newborns.