Nokea
A client's congestive heart failure has been treated, and he will soon be discharged. Discharge teaching should include instruction to call the physician if he notices a 2-lb weight gain in a 24-hour period. Increased weight gain may indicate:
- A. A diet too high in calories and saturated fat
- B. Decreasing cardiac output
- C. Decreasing renal function
- D. Development of diabetes insipidus
Correct Answer: B
Rationale: A 2-lb weight gain in 24 hours suggests fluid retention due to decreasing cardiac output, activating the renin-angiotensin-aldosterone system.
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Which of the following characterizes peer group relationships in eight- and nine-year-olds?
- A. Activities are usually cooperative and focused on a single best friend
- B. Activities are usually competitive with loosely organized groups
- C. Children usually play in groups with members of the same sex
- D. Children usually play in groups of three with mixed sexes
Correct Answer: C
Rationale: Eight- and nine-year-olds typically form same-sex peer groups, engaging in activities that foster social skills and group identity.
A 5-year-old child cries continually in her bed. Her parents have been unsuccessful in assisting her in expressing her feelings. Which activity should the nurse provide the child to assist her in expressing her feelings?
- A. Books with colorful pictures
- B. Music
- C. Riding toys
- D. Puppets
Correct Answer: D
Rationale: Puppets allow expression of feelings and fears that otherwise could not be directly communicated, helping the child articulate emotions.
A client with a diagnosis of HPV is at increased risk for which of the following?
- A. Hodgkin's lymphoma
- B. Cervical cancer
- C. Multiple myeloma
- D. Ovarian cancer
Correct Answer: B
Rationale: Human papillomavirus (HPV) is a major risk factor for cervical cancer particularly high-risk strains like HPV-16 and HPV-18. It is not strongly associated with Hodgkin’s lymphoma multiple myeloma or ovarian cancer.
An elderly patient has been taking 80 mg of furosemide (Lasix) bid. The nurse notes that the patient's most recent potassium level is 2.5mEq/L. The nurse should:
- A. Continue the medication as ordered
- B. Administer the morning dose only
- C. Give the medication with orange juice
- D. Withhold the medication and notify the physician
Correct Answer: D
Rationale: A potassium level of 2.5 mEq/L indicates hypokalemia, a serious side effect of furosemide, a potassium-wasting diuretic. The nurse should withhold the medication and notify the physician to address the electrolyte imbalance.
Which of the following diagnoses require droplet precautions?
- A. Varicella
- B. Rubella
- C. Streptococcal pharyngitis
- D. Scarlet fever
- E. Shigella
- F. Hepatitis A
Correct Answer: B, C, D
Rationale: Rubella (B), streptococcal pharyngitis (C), and scarlet fever (D) are transmitted via respiratory droplets, requiring droplet precautions. Varicella (A) requires airborne precautions, while Shigella (E) and hepatitis A (F) are transmitted fecally-orally, requiring contact precautions.