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A nurse is assessing a patient who has a history of deep vein thrombosis (DVT). Which of the following findings would be most concerning?

  • A. Pain and swelling in the leg.
  • B. Redness and warmth around the affected area.
  • C. Shortness of breath and chest pain.
  • D. Pale skin and decreased pulse in the affected leg.
Correct Answer: C

Rationale: The correct answer is C: Shortness of breath and chest pain. This is most concerning because it could indicate a pulmonary embolism, a serious complication of DVT where a blood clot travels to the lungs. Shortness of breath and chest pain are signs of compromised respiratory and cardiac function.

A: Pain and swelling in the leg are common symptoms of DVT but not as concerning as symptoms of a pulmonary embolism.
B: Redness and warmth around the affected area are typical signs of inflammation associated with DVT but do not indicate a life-threatening complication like a pulmonary embolism.
D: Pale skin and decreased pulse in the affected leg could be signs of compromised circulation due to DVT, but they are not as immediately life-threatening as symptoms of a pulmonary embolism.

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What should be the nurse's first action when caring for a client who has a suspected stroke?

  • A. Assess the client's airway
  • B. Administer oxygen
  • C. Administer aspirin
  • D. Perform a CT scan
Correct Answer: A

Rationale: The correct answer is A: Assess the client's airway. This is the first action because airway patency is the top priority in any emergency situation, including a suspected stroke. Ensuring the client can breathe effectively is crucial to prevent hypoxia and further complications. Administering oxygen (choice B) may be necessary after assessing the airway. Administering aspirin (choice C) should be done after a definitive diagnosis of an ischemic stroke. Performing a CT scan (choice D) is important for diagnosis but is not the first action to take in a suspected stroke scenario.

Which of the following statements is true regarding respect for differences?

  • A. All patients will behave in the same way when asked questions by a health care provider.
  • B. Conveying respect for differences will build trust and welcome patients to share their understandings.
  • C. Having cultural expectations is the key to understanding individual differences.
  • D. Expressing one's culture is largely dependent on the amount of his or her exposure to Canadian values.
Correct Answer: B

Rationale: The correct answer is B because conveying respect for differences helps build trust and encourages patients to share their perspectives openly. This fosters a positive patient-provider relationship and enhances communication. Choice A is incorrect as patients have unique behaviors. Choice C is incorrect as cultural expectations do not fully explain individual differences. Choice D is incorrect as expressing one's culture is not solely dependent on exposure to Canadian values.

What is the most appropriate action for a client with a history of asthma who is experiencing wheezing?

  • A. Administer albuterol
  • B. Administer antihistamines
  • C. Monitor for signs of infection
  • D. Administer epinephrine
Correct Answer: A

Rationale: The correct answer is A: Administer albuterol. Albuterol is a bronchodilator that helps open the airways, relieving wheezing in asthma patients. It is the first-line treatment for acute asthma exacerbations. Antihistamines (B) do not treat asthma symptoms. Monitoring for infection (C) is important but not the immediate action for wheezing. Epinephrine (D) is used for severe allergic reactions, not routine asthma management.

What is the priority action for a client who presents with symptoms of stroke?

  • A. Perform a CT scan
  • B. Monitor blood pressure
  • C. Administer aspirin
  • D. Administer thrombolytics
Correct Answer: A

Rationale: The correct answer is A: Perform a CT scan. This is the priority action because it helps determine if the stroke is ischemic or hemorrhagic, guiding treatment decisions. Monitoring blood pressure (B) is important but not the priority. Administering aspirin (C) can be considered after confirming the type of stroke. Administering thrombolytics (D) is indicated for ischemic stroke but should only be done after ruling out hemorrhagic stroke with a CT scan.

Which is an inappropriate item in planning care for a severely neutropenic client?

  • A. Transfuse neutrophils
  • B. Exclude raw vegetables
  • C. Avoid rectal suppositories
  • D. Prohibit vases of fresh flowers
Correct Answer: A

Rationale: The correct answer is A: Transfuse neutrophils. Neutrophil transfusion is not a standard treatment for neutropenia as neutrophils do not survive well outside the body. For the other choices: B: Excluding raw vegetables is correct to prevent infection. C: Avoiding rectal suppositories is correct to prevent mucosal injury. D: Prohibiting vases of fresh flowers is correct to prevent exposure to fungal spores. So, transfusing neutrophils is inappropriate as it is not a standard treatment for neutropenia.

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