Nokea
A client with a history of peptic ulcer disease is admitted with severe epigastric pain. Which finding requires immediate intervention?
- A. Nausea and vomiting.
- B. Hematemesis.
- C. Melena.
- D. Rebound tenderness.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A client with a history of heart failure is admitted with severe dyspnea. Which laboratory result requires immediate intervention?
- A. Blood glucose of 150 mg/dL.
- B. Serum potassium of 3.5 mEq/L.
- C. Serum creatinine of 1.0 mg/dL.
- D. Blood urea nitrogen (BUN) of 20 mg/dL.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The occupational heal th nurse is completing a yearly sel f-evaluation. Which activity shoul d the nurse document as an example of profi cient performance criteria i n professionalism?
- A. contri butesmoney to a professional society or organizati on
- B. mai ntai ns chai rmanship of the hospital nursi ng council
- C. documents t he nursi ng process in care care management
- D. develops pol icy i niti ati ves that impact occupati onal heal th and safety -
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. What is the priority nursing action?
- A. notify her parents
- B. refer her for prenatal care
- C. teach breast feeding methods
- D. offer nutritional instructions
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which intervention by the community health nurse is an example of a secondary level of prevention?
- A. providing a needle exchange program at a community mental health clinic
- B. developing an educational program for clients with diabetes mellitus
- C. administering influenza vaccines to residents of a nursing home
- D. initiating contact notifications for sexual partners of an HIV client
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The healthcare provider is caring for a client with a chest tube. Which intervention is most important to include in the plan of care?
- A. Maintain continuous suction on the chest tube.
- B. Clamp the chest tube during client movement.
- C. Ensure that the chest tube is clamped for at least 8 hours each day.
- D. Keep the collection chamber below the level of the chest.
Correct Answer: D
Rationale: Keeping the collection chamber below the level of the chest is crucial in caring for a client with a chest tube. This positioning helps ensure proper drainage of fluids and prevents complications such as backflow of drainage into the chest cavity. Option A is incorrect as continuous suction can lead to excessive drainage and tissue damage. Option B is incorrect as clamping the chest tube during client movement can cause a buildup of pressure and compromise proper drainage. Option C is incorrect because clamping the chest tube for extended periods can impede the drainage process, leading to potential complications.