Nokea
A client with a diagnosis of chronic heart failure is prescribed digoxin (Lanoxin). The nurse should monitor the client for which of the following signs of toxicity?
- A. Tachycardia.
- B. Yellow vision.
- C. Weight gain.
- D. Dry cough.
Correct Answer: B
Rationale: Yellow vision is a classic sign of digoxin toxicity, indicating the need for immediate evaluation.
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Which of the following types of restraints is best for the nurse to use for a child in the immediate postoperative period after cleft palate repair?
- A. Safety jacket.
- B. Elbow restraints.
- C. Wrist restraints.
- D. Body restraints.
Correct Answer: B
Rationale: Elbow restraints are most appropriate post-cleft palate repair to prevent the child from touching or damaging the surgical site while allowing some mobility.
The nurse is teaching a client with a new diagnosis of hypertension about lifestyle modifications. Which of the following recommendations is most effective?
- A. Increase calcium intake.
- B. Reduce alcohol consumption.
- C. Limit protein intake.
- D. Avoid potassium-rich foods.
Correct Answer: B
Rationale: Reducing alcohol consumption lowers blood pressure by decreasing vascular resistance and fluid retention.
Identify this cardiac rhythm strip. Fill in the blank. A. Idioventricular Rhythm B. Bundle Branch Block C. Sinus bradycardia D. Atrial Flutter
- B. Idioventricular Rhythm
- C. Bundle Branch Block
- D. Sinus bradycardia
- E. Atrial Flutter
Correct Answer: C
Rationale: Sinus bradycardia is characterized by a regular rhythm with a rate below 60 beats per minute, assuming the strip shows this pattern.
Which of the following are the five Rights of Supervision?
- A. The right task, the right circumstances, the right person, the right competency, and the right supervision or feedback
- B. The right task, the right circumstances, the right person, the right direction or communication, and the right supervision or feedback
- C. The right competency, the right education and training, the right scope of practice, the right environment and the right client condition
- D. The right competency, the right person, the right scope of practice, the right environment and the right client condition
Correct Answer: B
Rationale: The five Rights of Supervision are the right task, right circumstances, right person, right direction or communication, and right supervision or feedback . These ensure that delegated tasks are performed safely and effectively by the appropriate personnel under proper guidance.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed fluticasone (Flovent). The nurse should instruct the client to:
- A. Rinse the mouth after inhalation.
- B. Use the inhaler as needed for shortness of breath.
- C. Take the inhaler with meals.
- D. Stop the inhaler if dizziness occurs.
Correct Answer: A
Rationale: Rinsing the mouth after fluticasone inhalation prevents oral thrush.