Nokea
A client with a history of Addison's disease is prescribed hydrocortisone. Which instruction should the nurse include?
- A. Take it on an empty stomach
- B. Double the dose during stress
- C. Stop it if weight gain occurs
- D. Take it at bedtime only
Correct Answer: B
Rationale: Doubling hydrocortisone during stress (e.g., illness) prevents adrenal crisis in Addison's disease, mimicking the body's natural cortisol response.
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The nurse assesses the assigned clients for the shift. Of the following assigned clients, which client is at greatest risk for falling?
- A. A 22-year-old man with three fractured ribs and a fractured left arm.
- B. A 70-year-old woman with episodes of syncope.
- C. A 50-year-old man with angina.
- D. A 30-year-old woman with a fractured ankle.
Correct Answer: B
Rationale: Syncope increases fall risk due to sudden loss of consciousness, particularly in an elderly client with potential comorbidities.
A client who had a total knee replacement with a metal prosthesis is being prepared for discharge to home. Which statement by the client indicates to the nurse a need for further teaching?
- A. I can expect that changes in the shape of the knee will occur.
- B. I need to tell any future caregivers about the metal prosthesis.
- C. I need to report bleeding gums or tarry stools to the primary health care provider.
- D. I need to report fever, redness, or increased pain to the primary health care provider.
Correct Answer: A
Rationale: After a total knee replacement, the client should be taught to report any changes in the shape of the knee. This is not an expected event during recuperation from surgery. The client must notify caregivers of the metal implant because the client will need antibiotic prophylaxis for invasive procedures, and will be ineligible for magnetic resonance imaging as a diagnostic procedure. With a metal prosthesis, the client must be on anticoagulant therapy and should report adverse effects of this therapy, such as evidence of bleeding from a variety of sources. Fever, redness, or increased pain may indicate infection.
The nurse is assessing a client with suspected appendicitis. Which of the following findings supports this diagnosis?
- A. Pain at McBurney's point.
- B. Left lower quadrant pain.
- C. Decreased bowel sounds.
- D. Absence of fever.
Correct Answer: A
Rationale: Pain at McBurney's point (right lower quadrant) is a hallmark sign of appendicitis due to localized peritoneal irritation.
Which question is asked more than any other root cause analysis activity?
- A. What?
- B. Why?
- C. Who?
- D. When?
Correct Answer: B
Rationale: The 'Why?' question is central to root cause analysis, as it drives the investigation into the underlying causes of an event through techniques like the '5 Whys.'
The nurse is assessing an infant diagnosed with bacterial meningitis. The nurse should ask the parent if the infant has which of the following? Select all that apply.
- A. Fever.
- B. Vomiting.
- C. Diarrhea.
- D. Poor feeding.
- E. Abdominal pain.
Correct Answer: A,B,D
Rationale: Bacterial meningitis in infants commonly presents with fever, vomiting, and poor feeding. Diarrhea and abdominal pain are less typical symptoms in this age group.