Nokea
A client with cancer is admitted with suspected disseminated intravascular coagulation (DIC). Which laboratory finding supports this diagnosis?
- A. Prolonged prothrombin time (PT).
- B. Elevated hemoglobin.
- C. Normal platelet count.
- D. Decreased D-dimer.
Correct Answer: A
Rationale: DIC causes abnormal clotting and bleeding, leading to a prolonged prothrombin time (PT) due to consumption of clotting factors, supporting the diagnosis.
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Proper hand placement for chest compressions during cardiopulmonary resuscitation (CPR) is essential to reduce the risk of which complication?
- A. Gastrointestinal bleeding.
- B. Myocardial infarction.
- C. Emesis.
- D. Rib fracture.
Correct Answer: D
Rationale: Incorrect hand placement during CPR can cause rib fractures, which, while sometimes unavoidable, can be minimized with proper technique, such as placing hands at the center of the chest over the lower half of the sternum.
A 62-year-old Chinese man is admitted with multiple injuries from a motor vehicle accident. He complains of severe pain and requests frequent medication. One of the assistive nursing personnel expresses surprise, saying, "I thought Asian people were very stoic about pain." Which is the nurse's best response about pain?
- A. Expression and perception of pain vary widely from person to person.
- B. Tolerance of pain is the same in all people.
- C. Tolerance of pain is determined by a person's genetic makeup.
- D. Pain perception is the same in all people.
Correct Answer: A
Rationale: Pain expression and perception vary individually due to cultural, personal, and situational factors, countering the stereotype. Pain tolerance and perception are not uniform or solely genetic.
What is a goal of care for a client with acute renal failure?
- A. Maintain urine output of 30 mL/hour.
- B. Keep potassium above 5.5 mEq/L.
- C. Increase protein intake.
- D. Limit ambulation.
Correct Answer: A
Rationale: Maintaining adequate urine output indicates improving renal function.
During an initial assessment of a client diagnosed with vasospastic disorder (Raynaud's phenomenon), the nurse notes a sudden color change to white in the fingers. The nurse should first assess:
- A. Appearance of cyanosis
- B. Radial pulse
- C. SpO2 of the affected fingers
- D. Blood pressure
Correct Answer: B
Rationale: A sudden color change to white in Raynaud's indicates vasospasm. Assessing the radial pulse first confirms whether blood flow is present despite the vasospasm, guiding further action. Cyanosis, SpO2, and blood pressure are secondary, as pulse assessment is more immediate and specific.
A client refuses to look at or care for her colostomy. Which of the following statements by the nurse would be most appropriate?
- A. It has been 4 days since your surgery and you will be discussed. You have to learn to care for your colostomy before you leave the hospital.
- B. I think we will need to teach your husband to care for your colostomy if you are not going to be able to do it.
- C. I understand how you are feeling. It is important for you to feel attractive and you think having a colostomy changes your attractiveness.
- D. I can see that you are upset. Would you like to share your concerns with me?
Correct Answer: D
Rationale: It is important for the nurse to recognize that individuals go through a grieving process when adjusting to a colostomy. The nurse should be accepting and provide the client with opportunities to share her concerns and feelings when she is ready. Lecturing the client about the need to learn how to care for the colostomy is not productive, nor is attempting to shame her into caring for the colostomy by implying her husband will have to provide the care if she does not. It is not possible for the nurse to understand what the client is feeling. CN: Psychosocial adaptation; CL: Synthesize