Nokea
A nurse assists a male client with Parkinson's disease (PD) to ambulate in the hallway. The client appears to 'freeze' and then carefully lifts one leg and steps forward. He tells the nurse that he is pretending to step over a crack on the floor. How should the nurse respond?
- A. Re-orient the client to his present location and circumstances
- B. Confirm that this is an effective technique to help with ambulation
- C. Assist the client to a carpeted area where he can walk more easily
- D. Plan to assess the client's cognition after returning to his room
Correct Answer: B
Rationale: Pretending to step over a crack is a known technique that can help clients with PD overcome freezing episodes.
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A client with acquired immunodeficiency syndrome (AIDS) has impaired gas exchange from a respiratory infection. Which assessment finding warrants immediate intervention by the nurse?
- A. Elevated temperature
- B. Generalized weakness
- C. Diminished lung sounds
- D. Pain when swallowing
Correct Answer: D
Rationale: Pain when swallowing could indicate an opportunistic infection such as candidiasis, which requires prompt treatment.
Clinical diagnostic clues in an adolescent female with chronic cough:
- A. Pale stools and diarrhoea
- B. Aspergillus precipitin positive
- C. Calcified bronchopulmonary lymph nodes
- D. Whooping cough in the past
Correct Answer: B
Rationale: Aspergillus precipitin positive: A positive Aspergillus precipitin test indicates Aspergillus exposure, which could lead to chronic pulmonary issues, especially in immunocompromised individuals.
A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess:
- A. Pain
- B. Pulses
- C. Hemoglobin and hematocrit levels
- D. Catheterization report
Correct Answer: B
Rationale: Checking pulsesâ€â€especially in the canulated extremityâ€â€assures perfusion to that extremity and is the priority postprocedure.
In normal neonates:
- A. Extracellular fluid volume exceeds intracellular fluid volume
- B. In a term baby, plasma calcium levels exceed that of the mother
- C. Clamping the umbilical cord after cessation of cord pulsations increases the blood volume by 20% in the baby
- D. There are two arteries and one vein in the umbilical cord
Correct Answer: A
Rationale: In neonates, extracellular fluid volume is greater than intracellular fluid volume, reflecting the transition from intrauterine to extrauterine life.
A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of 117 mEq/L. Which nursing problem should the nurse include in this client's plan of care?
- A. Altered urinary elimination
- B. Impaired gas exchange
- C. Fluid volume excess
- D. Decreased cardiac output
Correct Answer: C
Rationale: Hyponatremia (low sodium level) is often associated with fluid volume excess in clients with lung carcinoma.