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A diagnosis of multiple sclerosis is often delayed because of the varied symptoms experienced by those affected with the disease. Which symptom is most common in those with multiple sclerosis?
- A. Resting tremors
- B. Double vision
- C. Flaccid paralysis
- D. Pill-rolling tremors
Correct Answer: B
Rationale: Double vision (diplopia) is a common early symptom of multiple sclerosis due to demyelination affecting cranial nerves, particularly the optic and oculomotor nerves.
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A 33-year-old male is being evaluated for possible acute leukemia. Which of the following findings is most likely related to the diagnosis of leukemia?
- A. The client collects stamps as a hobby.
- B. The client recently lost his job as a postal worker.
- C. The client had radiation for treatment of Hodgkin's disease as a teenager.
- D. The client's brother had leukemia as a child.
Correct Answer: C
Rationale: Prior radiation therapy, especially for Hodgkin's disease, is a known risk factor for developing leukemia due to DNA damage in bone marrow cells.
The nurse assesses a new order for a blood transfusion. The order is to transfuse 1 unit of packed red blood cells (contains 250 mL) in a 2-hour period. What will be the hourly rate of infusion?
- A. 50 mL/hr
- B. 62 mL/hr
- C. 125 mL/hr
- D. 137 mL/hr
Correct Answer: C
Rationale: To calculate the hourly rate: 250 mL ÷ 2 hours = 125 mL/hr, ensuring the transfusion is completed within the prescribed time.
While reviewing the chart of a client with a history of hepatitis B, the nurse finds a serologic marker of HBsAg. The nurse recognizes that the client:
- A. Has chronic hepatitis B
- B. Has recovered from hepatitis B infection
- C. Has immunity to infection with hepatitis C
- D. Has no chance of spreading the infection to others
Correct Answer: A
Rationale: Presence of HBsAg indicates active hepatitis B infection, either acute or chronic, and potential infectivity.
The nurse is working with a client who experiences orthostatic hypotension. Which suggestion would benefit the client?
- A. Sleep completely flat and do not use any pillows to prop your head.'
- B. Wear your support stockings when you sleep.'
- C. Take your blood pressure medicine immediately before trying to stand up.'
- D. Do not drink any liquids after 8 p.m.'
- E. None
- F. all the above
Correct Answer: E
Rationale: None of the options directly address orthostatic hypotension effectively. Support stockings during the day (not sleep), slow position changes, and adequate hydration are better strategies.
The nurse is working in the emergency room when a client arrives with severe burns of the left arm, hands, face, and neck. Which action should receive priority?
- A. Starting an IV
- B. Applying oxygen
- C. Obtaining blood gases
- D. Medicating the client for pain
Correct Answer: B
Rationale: Applying oxygen is the priority to ensure airway patency and oxygenation in a client with facial and neck burns, which can cause airway compromise.