Nokea
A client's admission history reveals complaints of fatigue, chronic sore throat, and enlarged lymph nodes in the axilla and neck. Which exam would assist the physician to make a tentative diagnosis of leukemia?
- A. A complete blood count
- B. An x-ray of the chest
- C. A bone marrow aspiration
- D. A CT scan of the abdomen
Correct Answer: A
Rationale: A complete blood count (CBC) is the initial test for leukemia, revealing abnormal white blood cell counts, anemia, or thrombocytopenia, supporting a tentative diagnosis.
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The nurse is performing an initial assessment of a newborn Caucasian male delivered at 32 weeks gestation. The nurse can expect to find the presence of:
- A. Mongolian spots
- B. Scrotal rugae
- C. Head lag
- D. Polyhydramnios
Correct Answer: C
Rationale: Head lag is expected in a preterm newborn at 32 weeks due to underdeveloped neck muscle strength.
The nurse should visit which of the following clients first?
- A. The client with diabetes with a blood glucose of 95 mg/dL
- B. The client with hypertension being maintained on Lisinopril
- C. The client with chest pain and a history of angina
- D. The client with Raynaud's disease
Correct Answer: C
Rationale: Chest pain in a client with a history of angina suggests possible cardiac ischemia, requiring immediate assessment.
An end-of-life client receiving home hospice care states he no longer wants to eat. The nurse should
- A. speak with the health care provider about inserting a feeding tube.
- B. encourage the client to eat small, nutritious meals.
- C. accept the client's decision and work to make the client comfortable.
- D. ask the client's family to bring the client's favorite foods.
Correct Answer: C
Rationale: In hospice care, respecting the client’s autonomy is key. Accepting the decision to stop eating and focusing on comfort aligns with end-of-life care principles.
A Mexican-American client states that she and her family live next door to her brother and his family and that they share goods, services, and childcare. How is this type of family classified?
- A. Nuclear
- B. Dual career/dual earner
- C. Extended
- D. Extended kin network
Correct Answer: D
Rationale: An extended kin network (D) involves close-knit families sharing resources and responsibilities, as described.
A client with obsessive compulsive personality disorder annoys his coworkers with his rigid-perfectionistic attitude and his preoccupation with trivial details. An important nursing intervention for this client would be:
- A. Helping the client develop a plan for changing his behavior
- B. Contracting with him for the time he spends on a task
- C. Avoiding a discussion of his annoying behavior because it will only make him worse
- D. Encouraging him to set a time schedule and deadlines for himself
Correct Answer: D
Rationale: Setting a time schedule helps the client manage perfectionistic tendencies by structuring tasks, reducing preoccupation with trivial details.