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A client with chronic heart failure has atrial fibrillation and a left ventricular ejection fraction of 15%. The client is taking warfarin (Coumadin). The expected outcome of this drug is to:
- A. Decrease circulatory overload.
- B. Improve the myocardial workload.
- C. Prevent thrombus formation.
- D. Regulate cardiac rhythm.
Correct Answer: C
Rationale: Warfarin prevents thrombus formation, critical in atrial fibrillation and low ejection fraction, which increase clot risk due to stasis.
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Doxorubicin (Adriamycin) is prescribed for a female client with breast cancer. The client is distressed about hair loss. The nurse should do which of the following?
- A. Have the client wash and massage the scalp daily to stimulate hair growth.
- B. Explain that hair loss is temporary and will quickly grow back to its original appearance.
- C. Provide resources for a wig selection before hair loss begins.
- D. Recommend that the client limit social contacts until hair regrows.
Correct Answer: C
Rationale: Providing resources for wig selection before hair loss begins helps the client prepare for and cope with chemotherapy-induced alopecia, maintaining her self-esteem.
A client has been admitted with draining foot lesions. The nurse should do which of the following? Select all that apply.
- A. Place the client in a room with negative air pressure.
- B. Admit the client to a semi-private room.
- C. Admit the client to a private room.
- D. Post a "contact isolation" sign on the door.
- E. Wear a protective gown when in the client's room.
- F. Wear latex-free gloves when providing direct care.
Correct Answer: C,D,E,F
Rationale: Draining lesions require contact precautions, including a private room, isolation signage, gowns, and gloves (latex-free to avoid allergies). Negative pressure is for airborne pathogens.
Interferon alfa-2b (Intron A) has been prescribed to treat a client with chronic hepatitis B. The nurse should assess the client for which of the following adverse effects?
- A. Retinopathy.
- B. Constipation.
- C. Flulike symptoms.
- D. Hypoglycemia.
Correct Answer: C
Rationale: Interferon alfa-2b commonly causes flulike symptoms (C), such as fever, chills, and fatigue, which are expected adverse effects. Retinopathy (A), constipation (B), and hypoglycemia (D) are not typically associated with this medication.
The nurse is developing a care plan for a client with a hearing impairment. Which of the following interventions should the nurse take? Select all that apply.
- A. Ensure that the room is well lit when communicating with the client.
- B. Use non-verbal forms of communication like gestures and sign language, if applicable.
- C. Speak loudly and shout when communicating with the client.
- D. Face the client directly when speaking.
- E. Provide written information as needed.
Correct Answer: A,B,D,E
Rationale: For hearing impairment, a well-lit room aids lip-reading, non-verbal communication and facing the client directly improve understanding, and written information supports communication. Shouting can distort speech and is not effective.
Which of the following signs and symptoms are common in male clients with prolactin-secreting tumors?
- A. Severe lethargy and fatigue.
- B. Erectile dysfunction and decreased libido.
- C. Both of the above
- D. None of the above
Correct Answer: B
Rationale: Prolactin-secreting tumors in males often cause erectile dysfunction and decreased libido due to suppression of testosterone.