Nokea
A client with chronic pancreatitis is receiving Pancreatin. Which of the following observations is most indicative that the drug treatment is having the desired effect?
- A. The client's appetite is improved.
- B. The client's weight loss is greater than 10 pounds.
- C. The client's stools contain less fat and occur with less frequency.
- D. The client's tissue bruises less easily.
Correct Answer: C
Rationale: Pancreatin replaces pancreatic enzymes, aiding fat digestion. Reduced fat in stools and less frequent bowel movements indicate effective treatment. Appetite improvement is secondary, weight loss is undesirable, and bruising is unrelated.
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The most common reason for an Apgar score of 8 and 9 in a newborn is an abnormality of what parameter?
- A. Heart rate
- B. Muscle tone
- C. Cry
- D. Color
Correct Answer: D
Rationale: Color. Acrocyanosis (blue hands and feet) is the most common Apgar score deduction, and is a normal adaptation in the newborn.
Which of the following cutaneous manifestations is associated with Lyme disease?
- A. Annular rash
- B. Papular crusts
- C. Bullae
- D. Plaques
Correct Answer: A
Rationale: Lyme disease is characterized by an annular (erythema migrans) rash, often with a bull's-eye appearance, at the site of the tick bite.
The nurse is observing a staff member perform ear irrigation for an adult client with impacted cerumen. The nurse should intervene if the staff member is observed
- A. using a slow, steady flow of solution to irrigate the ear canal
- B. placing the client in a lying position with the head tilted toward the affected ear
- C. straightening the ear canal by pulling the pinna down and back
- D. directing the tip of the syringe and irrigation solution toward the top of the ear canal
Correct Answer: C
Rationale: Pulling the pinna down and back is incorrect for adults; it should be up and back. Slow flow , head tilt , and directing solution upward are correct.
All of the following clients are on the unit. Which one is most likely to develop urinary retention?
- A. A woman who had a modified radical mastectomy yesterday
- B. A man who had an abdominal cholecystectomy this morning
- C. A woman who had an abdominal hysterectomy yesterday
- D. A man who had surgery for a ruptured appendix
Correct Answer: C
Rationale: Abdominal hysterectomy involves pelvic manipulation, increasing urinary retention risk due to bladder trauma or nerve disruption. Other surgeries pose lower risk.
A 7 year-old child is hospitalized following a major burn to the lower extremities. A diet high in protein and carbohydrates is recommended. The nurse informs the child and family that the most important reason for this diet is to
- A. Promote healing and strengthen the immune system
- B. Provide a well balanced nutritional intake
- C. Stimulate increased peristalsis absorption
- D. Spare protein catabolism to meet metabolic needs
Correct Answer: D
Rationale: Spare protein catabolism to meet metabolic needs. A high-carbohydrate diet prevents protein breakdown for energy, allowing proteins to restore tissue.