Nokea
A client with a family history of Huntington's disease asks the nurse for information on how the disease is transmitted. Which of the following statements indicates that she understands the nurse's teaching?
- A. The chances of my passing the disease to my child are 1 in 2
- B. I have no chance of passing the disease to a male child, but a female child would carry the disease
- C. I have no chance of passing the disease to a female child, but a male child will have the disease
- D. The chances of my passing the disease to my child are 1 in 4
Correct Answer: A
Rationale: Huntington's disease is autosomal dominant, meaning there is a 50% (1 in 2) chance of passing the gene to each child, regardless of sex.
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A client has a nasogastric tube in place after extensive abdominal surgery. The client complains of nausea. His abdomen is distended, and there are no bowel sounds.
The FIRST nursing action should be to
- A. administer the PRN pain medication and an antiemetic.
- B. irrigate the nasogastric tube with normal saline.
- C. determine if the nasogastric tube is patent and draining.
- D. check the placement of the nasogastric tube by auscultation.
Correct Answer: C
Rationale: Strategy: Answers are a mix of assessments and implementations. Is this a situation that requires assessment? Yes. (1) implementation, may be carried out after the patency of the tube is determined (2) implementation, patency should be checked first (3) correct-should first assess if the tube is open and draining to determine if there is a problem with the nasogastric tube; if it is patent and draining it does not need to be irrigated (4) assessment, patency should be checked first by aspirating stomach contents, not by auscultation
After the anesthesiologist administers an epidural to a woman in labor, which of the following nursing actions has the HIGHEST priority?
- A. Decrease IV fluids.
- B. Assess the fetal heart monitor.
- C. Place the mother on her right side.
- D. Obtain the blood pressure.
Correct Answer: D
Rationale: Epidural anesthesia can cause hypotension, making blood pressure monitoring the priority to detect complications. Options A, B, and C are secondary or incorrect.
A client is seen in the emergency room with complaints of chest pain.
- A. Which assessment finding suggests to the nurse that the client’s chest pain is cardiac in origin?
- B. The client states that the pain is sharp and increased by deep breathing.
- C. The client reports a history of a fatty meal before the pain began.
- D. The client states that the pain is substernal and radiates to the left arm.
- E. The client reports that the pain began when he was lifting a heavy object.
Correct Answer: C
Rationale: Substernal chest pain radiating to the left arm is a classic symptom of cardiac ischemia, such as angina or myocardial infarction. Sharp pain with breathing suggests pleuritic causes, fatty meals indicate gastroinTest inal issues, and pain with lifting suggests musculoskeletal strain.
A client is scheduled for a cardiac catheterization at 8 AM. The client's laboratory work was completed five days ago. The results were: K⺠3.0 mEq/L, Na⺠148 mEq/L, glucose 178 mg/dL. He complains of muscle weakness and cramps.
Which of the following nursing actions is BEST?
- A. Administer the 7 AM dose of spironolactone (Aldactone).
- B. Encourage eating bananas for breakfast.
- C. Obtain stat K⺠level.
- D. Call for twelve-lead EKG.
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) Aldactone is potassium-sparing diuretic and is an oral medication, patient is NPO for procedure (2) is not feasible prior to the cardiac cath because the client is NPO (3) correct-signs and symptoms are indicative of hypokalemia; stat serum K⺠level is needed to confirm the K⺠level prior to going for cardiac catheterization (4) is unnecessary at this time
The nurse is caring for a client with a history of sickle cell disease.
- A. Which intervention is most effective during a sickle cell crisis?
- B. Administer oxygen therapy.
- C. Encourage ambulation.
- D. Apply cold compresses to painful areas.
- E. Restrict fluid intake.
Correct Answer: A
Rationale: Oxygen therapy improves oxygenation, reducing sickling and tissue hypoxia during a sickle cell crisis. Ambulation is limited, cold compresses worsen vasoconstriction, and fluids are encouraged to prevent dehydration.