Nokea
A client with an inguinal hernia asks the nurse why he should have surgery when he has had a hernia for years. The nurse understands that surgery is recommended to:
- A. Prevent strangulation of the bowel
- B. Prevent malabsorptive disorders
- C. Decrease secretion of bile salts
- D. Increase intestinal motility
Correct Answer: A
Rationale: Surgery for an inguinal hernia is recommended to prevent strangulation, where the herniated bowel becomes trapped, leading to ischemia. The other options are not primary concerns.
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A client is admitted with symptoms of vertigo and syncope.
- A. Memory loss and disorientation
- B. Numbness in the face, mouth, and tongue
- C. Radial pulse differences over 10 bpm
- D. Frontal headache with associated nausea or emesis
Correct Answer: C
Rationale: Left subclavian artery obstruction can cause subclavian steal syndrome, leading to vertigo, syncope, and radial pulse differences (>10 bpm) due to blood flow reversal. Memory loss (A), numbness (B), and headache (D) are unrelated.
The nurse is caring for a client with a history of heart failure. Which discharge instruction is most important?
- A. Weigh yourself daily.'
- B. Limit exercise to 10 minutes daily.'
- C. Increase sodium intake.'
- D. Take over-the-counter pain relievers as needed.'
Correct Answer: A
Rationale: Daily weight monitoring detects fluid retention early in heart failure, allowing timely intervention. Exercise should be moderate, sodium restricted, and pain relievers used cautiously.
The client with a history of gout is prescribed allopurinol (Zyloprim). The nurse should instruct the client to:
- A. Limit fluid intake to prevent urinary complications.
- B. Take the medication with a full glass of water.
- C. Avoid foods high in calcium.
- D. Take the medication on an empty stomach.
Correct Answer: B
Rationale: Allopurinol reduces uric acid production, and taking it with a full glass of water promotes excretion of uric acid, preventing kidney stones. Fluid restriction is harmful, calcium is not restricted, and it can be taken with food.
A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant twice before; the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the gravida and para system to record the client's obstetrical history, the nurse should record:
- A. Gravida 3 para 1
- B. Gravida 3 para 2
- C. Gravida 2 para 1
- D. Gravida 2 para 2
Correct Answer: B
Rationale: Gravida=3 (current pregnancy), Para=2 (two births after 20 weeks).
A primipara is assessed on arrival to the postpartum unit. The nurse finds her uterus to be boggy. The nurse's first action should be to:
- A. Call the physician
- B. Assess her vital signs
- C. Give the prescribed oxytocic drug
- D. Massage her fundus
Correct Answer: D
Rationale: The nurse should first implement independent and dependent measures to achieve uterine tone before calling the physician. Assessment of vital signs will not help to restore uterine atony, which is the priority need. Giving a prescribed oxytocic drug would be necessary if the uterus did not maintain tone with massage. Fundal massage generally restores uterine tone within a few moments and should be attempted first.