Nokea
A healthcare provider is planning to delegate client assignments to the assistive personnel. Which of the following tasks is appropriate for the healthcare provider to delegate?
- A. Adjusting the flow rate of the client's oxygen tank.
- B. Collecting a urine sample.
- C. Measuring the client's pain level.
- D. Transporting a client to x-ray.
Correct Answer: D
Rationale: The correct answer is 'D: Transporting a client to x-ray.' This task is appropriate for delegation to assistive personnel as it involves transferring the client safely from one location to another, which does not require the specialized skills of a healthcare provider. Adjusting the flow rate of the client's oxygen tank (Choice A) involves making clinical decisions that should be done by a licensed healthcare provider. Collecting a urine sample (Choice B) and measuring the client's pain level (Choice C) require critical thinking and assessment skills that are typically within the scope of practice of licensed healthcare providers, not assistive personnel.
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A client is being discharged with a new prescription for levothyroxine. Which of the following instructions should the nurse include?
- A. Take this medication with meals to avoid stomach upset.
- B. Take this medication at the same time every day.
- C. Notify your provider if you experience chest pain or palpitations.
- D. Take this medication with antacids to reduce indigestion.
Correct Answer: B
Rationale: The correct answer is B: 'Take this medication at the same time every day.' It is crucial to take levothyroxine at the same time each day to maintain consistent thyroid hormone levels. Choice A is incorrect because levothyroxine should be taken on an empty stomach, usually in the morning. Choice C is important but not specific to the administration of levothyroxine. Choice D is incorrect as antacids can interfere with the absorption of levothyroxine.
Which electrolyte imbalance is a common concern in patients receiving loop diuretics?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct Answer: C
Rationale: The correct answer is Hypokalemia (Choice C). Loop diuretics can lead to potassium loss in the urine, resulting in hypokalemia. This electrolyte imbalance is a common concern with loop diuretic therapy and necessitates regular monitoring. Hyperkalemia (Choice A) is not typically associated with loop diuretics but with conditions like renal failure. Hyponatremia (Choice B) is more common with thiazide diuretics. Hypercalcemia (Choice D) is not a typical concern with loop diuretic use.
A nurse is caring for a client who is postoperative following a hip arthroplasty. Which of the following actions should the nurse take to prevent dislocation of the prosthesis?
- A. Place a pillow between the client's legs.
- B. Place the client in a high Fowler's position.
- C. Maintain the client in a side-lying position.
- D. Keep the client's legs elevated.
Correct Answer: A
Rationale: Placing a pillow between the client's legs is the correct action to prevent dislocation of the prosthesis after hip arthroplasty. This positioning helps maintain proper alignment and stability of the hip joint, reducing the risk of dislocation. Placing the client in a high Fowler's position (choice B) is not recommended after hip arthroplasty as it may strain the hip joint. Maintaining the client in a side-lying position (choice C) or keeping the client's legs elevated (choice D) does not provide the same level of support and alignment as placing a pillow between the legs.
When managing blood pressure at home, which statement by the client indicates an understanding of the teaching provided by a nurse for hypertension?
- A. I will take my medication only when I feel dizzy.
- B. I will check my blood pressure at least once a week.
- C. I will stop taking my medication once my blood pressure is within normal range.
- D. I will sit quietly for 5 minutes before measuring my blood pressure.
Correct Answer: D
Rationale: The correct answer is D because sitting quietly for 5 minutes before measuring blood pressure ensures an accurate reading and helps monitor hypertension. Choice A is incorrect as medications for hypertension should be taken as prescribed, not based on symptoms like dizziness. Choice B is not ideal as blood pressure should be checked more frequently, preferably daily. Choice C is incorrect as stopping medication abruptly once blood pressure is normal can lead to rebound hypertension.
What is the priority nursing action for a patient with shortness of breath?
- A. Administer oxygen
- B. Reposition the patient
- C. Check oxygen saturation
- D. Elevate the head of the bed
Correct Answer: A
Rationale: Administering oxygen is the priority nursing action for a patient experiencing shortness of breath. Oxygen therapy aims to improve oxygenation levels quickly, addressing the underlying cause of the symptom. Repositioning the patient, checking oxygen saturation, and elevating the head of the bed are important interventions but administering oxygen takes precedence in this scenario to ensure adequate oxygen supply to the body.