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A client with atrial fibrillation is being discharged home after being stabilized with medications, including digoxin. Which client statement regarding digoxin toxicity indicates that reinforcement of the discharge education is needed?
- A. I must visit my health care provider to check my drug levels.
- B. I should report to my health care provider if I develop nausea and vomiting.
- C. I should tell my health care provider if my heart rate is below 60 beats per minute.
- D. I will need to increase my potassium intake.
Correct Answer: D
Rationale: Increasing potassium intake is incorrect and risky with digoxin, as it can affect drug levels. Other statements reflect correct understanding.
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A client is seen in the clinic and determined to have a hydatidiform mole. Which diagnostic test can confirm the diagnosis of a hydatidiform mole?
- A. An ultrasound
- B. Alpha-fetoprotein
- C. Human chorionic gonadotrophin
- D. Lecithin sphingomyelin ratio
Correct Answer: A
Rationale: Ultrasound is the primary diagnostic tool for confirming a hydatidiform mole, showing a characteristic 'snowstorm' pattern. Elevated human chorionic gonadotropin supports the diagnosis but is not confirmatory alone.
The nurse is observing a client who sustained a left ankle sprain ascending the stairs using a modified 3-point gait. The nurse should intervene if the client is observed
- A. bearing weight on the right leg
- B. realigning the crutches between each step
- C. assuming the tripod position before ascending the stairs
- D. using the right crutch to support the weight while advancing the left leg onto the next step
Correct Answer: D
Rationale: In a modified 3-point gait, the injured leg (left) should not bear weight, and the right crutch with the left leg should not be used alone to advance. The other actions are consistent with proper crutch use.
A 6 month-old infant who is being treated for developmental dysplasia of the hip has been placed in a hip spica cast. The nurse should teach the parents to
- A. Gently rub the skin with a cotton swab to relieve itching
- B. Place the favorite books and push-pull toys in the crib
- C. Check every few hours for the next day or 2 for swelling in the baby's feet
- D. Turn the baby with the abduction stabilizer bar every 2 hours
Correct Answer: C
Rationale: Check every few hours for the next day or 2 for swelling in the baby's feet. A child in a hip spica cast must be checked for circulatory impairment. The extremities are observed for swelling, discoloration, movement and sensation.
The nurse is reinforcing teaching about circumcision care with the parent of a newly circumcised newborn. Which statement by the parent would require follow-up?
- A. I should change my baby's diaper at least every 4 hours.
- B. I should notify the health care provider if there is odorous discharge from the site.
- C. I will apply light pressure with gauze if there is bleeding at the site.
- D. I will clean the site with alcohol-based wipes or soap and water.
Correct Answer: D
Rationale: Alcohol-based wipes are too harsh for a circumcision site; gentle soap and water are recommended, requiring follow-up. Other statements are correct.
The nurse is preparing the room of a client returning from a subtotal thyroidectomy. Which item should be placed at the bedside of a client with a subtotal thyroidectomy?
- A. An ambu bag
- B. A tracheostomy set
- C. An endotracheal tube
- D. A ventilator
Correct Answer: B
Rationale: A tracheostomy set is essential post-thyroidectomy due to the risk of airway obstruction from swelling or hematoma. Other equipment is less immediately relevant.