Nokea
A client who had a splenectomy is being discharged. Of the following discharge instructions, which is most specific to the client's surgical procedure?
- A. Do not drive.
- B. Alternate rest and activity.
- C. Make an appointment for the staples to be removed.
- D. Report early signs of infection.
Correct Answer: D
Rationale: Splenectomy increases the lifelong risk of infection due to the spleen's role in immunity. Reporting early signs of infection is the most specific instruction, as it addresses this unique risk. The other instructions are general postoperative advice.
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Ventricular tachycardia is displayed on the cardiac monitor of a client admitted to the telemetry unit. Which should the nurse do first?
- A. Prepare for immediate cardioversion.
- B. Begin cardiopulmonary resuscitation (CPR).
- C. Check for a pulse.
- D. Prepare for immediate defibrillation.
Correct Answer: C
Rationale: Checking for a pulse determines if ventricular tachycardia is pulseless (requiring defibrillation) or stable (possibly requiring cardioversion or medication).
The nurse instructs the client on health maintenance activities to help control symptoms from her hiatal hernia. Which of the following statements would indicate that the client has understood the instructions?
- A. I'll avoid lying down after a meal.'
- B. I can still enjoy my potato chips and cola at bedtime.'
- C. I wish I didn't have to give up swimming.'
- D. If I wear a girdle, I'll have more support for my stomach.'
Correct Answer: A
Rationale: Avoiding lying down after meals prevents reflux, indicating the client understands hiatal hernia management. The other statements are incorrect or irrelevant.
Multiple clients have been brought to the emergency department after being struck by lightning during a severe thunderstorm. Which of the following clients should the nurse prioritize? The client who?
- A. reports numbness and tingling in all their extremities.
- B. has paralysis on both lower extremities.
- C. is confused and cannot remember their name or why they are in the emergency department.
- D. experienced a massive electrical current discharge to their body.
Correct Answer: B
Rationale: Paralysis in both lower extremities indicates potential spinal cord injury or severe neurological damage, requiring immediate prioritization. Numbness and tingling (A) suggest peripheral nerve issues, confusion (C) may indicate concussion or hypoxia, and massive discharge (D) lacks specific clinical urgency without symptoms.
When a client is diagnosed with aplastic anemia, the nurse should assess the client for changes in which of the following physiologic functions?
- A. Bleeding tendencies.
- B. Intake and output.
- C. Peripheral sensation.
- D. Bowel function.
Correct Answer: A
Rationale: Aplastic anemia causes pancytopenia, including thrombocytopenia, which increases the risk of bleeding. The nurse should assess for bleeding tendencies, such as petechiae, bruising, or mucosal bleeding. Intake/output, sensation, and bowel function are not primarily affected.
Which of the following factors assists a person to achieve positive bereavement outcomes?
- A. Young age.
- B. History of anxiety.
- C. History of depression.
- D. Higher socioeconomic status.
Correct Answer: D
Rationale: Higher socioeconomic status provides access to resources (e.g., counseling, support groups), which can facilitate positive bereavement outcomes.