Nokea
A hyperactive client is experiencing flight of ideas. The most therapeutic activity for him would be:
- A. Doing crafts in occupational therapy
- B. Working a 1000-piece puzzle
- C. Playing bridge with three other clients
- D. Playing basketball in the gym
Correct Answer: D
Rationale: This activity would allow the client to channel his energy in a positive way, suitable for his hyperactive state and limited attention span.
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A client admitted with a diagnosis of possible myocardial infarction is admitted to the unit from the emergency room. The nurse's first action when admitting the client will be to:
- A. Obtain vital signs
- B. Connect the client to the cardiac monitor
- C. Ask the client if he is still having chest pain
- D. Complete the history profile
Correct Answer: B
Rationale: Obtaining vital signs is important after connecting the client to the monitor because vital signs should be stable before the client is discharged from the emergency room. All are important, but the first priority is to monitor the client's rhythm. If the client is in severe pain, pain medication should be given after connecting him to the monitor and obtaining vital signs. Completion of the history profile is the least important of the nursing actions.
A client with a history of atrial fibrillation is admitted with complaints of palpitations. The nurse should expect the client to have:
- A. Irregular pulse
- B. Bradycardia
- C. Hypertension
- D. Chest pain
Correct Answer: A
Rationale: Atrial fibrillation causes an irregular pulse due to disorganized atrial contractions, a hallmark of the condition.
A client's wife is concerned over his behavior in recent months. He has been diagnosed with Parkinson's disease, and she is telling his nurse that he has been doing 'strange things.' The nurse reassures the wife that the following behavior is normal with Parkinson's disease:
- A. Your husband will experience some periods of muscle flaccidity. Be sure to make him sit down during these periods.'
- B. Your husband may move his hands in motions that look like he is rolling a pill between his fingers.'
- C. Twitching of the muscles is to be expected and can occur at any time during the day.'
- D. Parkinson's disease causes severe pain in the joints. You should give your husband Tylenol at those times.'
Correct Answer: B
Rationale: Clients with Parkinson's disease generally experience stiffness and rigid movement. Pill-rolling movements are a symptom experienced by the Parkinson client. Twitching of the muscles is not an expected symptom of Parkinson's disease. Parkinson's disease does not cause joint pain. Mild muscular pain may be present.
A 19-year-old client has sustained a C-7 fracture, which resulted in his spinal cord being partially transected. By 2 weeks' postinjury, his neck has been surgically stabilized, and he has been transferred from the intensive care unit. A potential life-threatening complication the nurse monitors the client for is:
- A. Autonomic dysreflexia
- B. Bradycardia
- C. Central cord syndrome
- D. Spinal shock
Correct Answer: A
Rationale: Autonomic dysreflexia, a life-threatening exaggerated sympathetic response, can occur in spinal cord injuries above T6, causing severe hypertension.
A client is receiving peritoneal dialysis. He has been taught to warm the dialyzing fluid prior to instilling it because:
- A. Warmed solution helps keep the body temperature maintained within a normal range during instillation
- B. Warmed solution helps dilate the peritoneal blood vessels
- C. Warmed solution decreases the risk of peritoneal infection
- D. Warmed solution promotes a relaxed abdominal muscle
Correct Answer: B
Rationale: Instilling a cool solution does not significantly lower the body temperature during peritoneal dialysis. Warmed solution does help dilate the peritoneal blood vessels, facilitating the exchange of fluids. Warming the dialysate does not decrease the risk of peritoneal infection. Sterile technique decreases this risk. Relaxing the abdominal muscles does not facilitate peritoneal dialysis.