Nokea
A female client seen in the health department's STD clinic is diagnosed with chlamydia. Before the client leaves the clinic, the nurse should:
- A. Obtain the names and addresses of the client's sexual contacts.
- B. Tell the client to avoid alcohol while taking her prescription for Flagyl.
- C. Instruct the client to avoid sexual relations until the infection is resolved.
- D. Tell the client to douche after sexual intercourse.
Correct Answer: C
Rationale: Avoiding sexual relations prevents chlamydia spread until treatment is complete. Contact tracing is secondary, Flagyl is for trichomoniasis, and douching is harmful.
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The nurse is reinforcing teaching for a client with bipolar disorder who has a new prescription for lithium. Which of the following statements by the client would require follow-up?
- A. I should drink at least 2 to 3 L of fluid daily.'
- B. I can take over-the-counter ibuprofen for pain relief.'
- C. I will maintain a consistent dietary intake of sodium.'
- D. I should have my medication levels checked periodically.'
Correct Answer: B
Rationale: Ibuprofen (B) can increase lithium toxicity, requiring follow-up. Adequate fluid intake (A), consistent sodium (C), and periodic level checks (D) are correct.
The nurse is assisting with care of a client with blunt head injury admitted for observation, including hourly neurologic checks. At 1:00 AM, the client reports a headache; the neurologic check is normal, and the nurse administers acetaminophen prn. At 2:00 AM, the client appears to be sleeping. What action does the nurse anticipate taking?
- A. Arouse the client and ask what the current month is
- B. Awaken the client and check for paresthesia
- C. Document 'relief apparently obtained' and recheck at 3:00 AM
- D. Let the client sleep but verify respiratory rate
Correct Answer: A
Rationale: Hourly neurologic checks require arousing the client to assess orientation (A). Checking paresthesia (B), assuming relief (C), or only verifying respiratory rate (D) do not meet monitoring requirements.
The nurse is collecting data from a 10-year-old client during a routine physical examination. Which of the following actions should the nurse take? Select all that apply.
- A. Use correct anatomical terminology while reinforcing teaching about self-care.
- B. Conduct a head-to-toe examination in the same sequence as an adult examination.
- C. Explain the purpose of the examination equipment and any procedures to the client.
- D. Offer the client a gown and allow the client to keep the underwear on during the examination.
- E. Ask the accompanying parent to rate and describe any pain the client may be experiencing.
Correct Answer: A, C, D
Rationale: Using anatomical terminology (A) promotes understanding. Explaining equipment and procedures (C) reduces anxiety. Offering a gown and allowing underwear (D) respects privacy. Adult examination sequences (B) may not suit pediatric needs, and parents rating pain (E) may not accurately reflect the child's experience.
The nurse is caring for an ambulatory client who has a new order for continuous cardiac monitoring via a portable unit. It would require follow-up if the nurse
- A. verifies that gel is present on each electrode and is not dried out
- B. cleanses and dries the skin before placing the electrodes on the client
- C. clips excessive hair off the client before applying the electrodes
- D. places one electrode each on the client's upper and lower extremities
Correct Answer: D
Rationale: Placing electrodes on extremities (D) is incorrect for cardiac monitoring, which requires chest placement. Verifying gel (A), cleansing skin (B), and clipping hair (C) are appropriate.
The nurse is caring for a post-surgical client at risk for developing deep vein thrombosis. Which intervention is an effective preventive measure?
- A. Place pillows under the knees
- B. Use elastic stockings continuously
- C. Encourage range of motion and ambulation
- D. Massage the legs twice daily
Correct Answer: C
Rationale: Encourage range of motion and ambulation. Mobility reduces the risk of deep vein thrombosis in the post-surgical client and the adult at risk due to other factors.