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A nurse is caring for a client who has a new diagnosis of chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?
- A. Barrel chest
- B. Bradypnea
- C. Hypoxemia
- D. Weight gain
Correct Answer: C
Rationale: Hypoxemia is expected in COPD due to impaired gas exchange, leading to low oxygen levels in the blood.
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A nurse is reinforcing teaching with a new mother about facility security measures. Which of the following statements by the mother indicates an understanding of the teaching?
- A. I will carry my baby to the nursery.
- B. I will have an identification band that matches the one my baby wears.
- C. I can remove my security band to give to a family member.
- D. I can take my baby to the lobby to visit family.
Correct Answer: B
Rationale: Having an identification band that matches the baby's band is correct. Hospital security protocols require that the mother and baby wear matching identification bands to ensure the right baby is with the right parent and prevent infant abduction or misidentification.
A nurse overhears two assistive personnel (AP) in the nurses' station discussing a client who was recently admitted. Which of the following actions should the nurse take?
- A. Tell the APs to stop the conversation.
- B. Document the event in the client's progress notes.
- C. Inform the client of the APs' actions.
- D. Submit an incident report to the risk manager.
Correct Answer: A
Rationale: Telling the APs to stop the conversation is correct. Discussing client information in a public area violates HIPAA (Health Insurance Portability and Accountability Act) privacy regulations. The nurse should immediately intervene and remind the APs about maintaining client confidentiality.
A nurse is caring for a client who has a new diagnosis of hypertension. Which of the following lifestyle modifications should the nurse recommend?
- A. Increase sodium intake.
- B. Limit physical activity.
- C. Reduce stress.
- D. Avoid calcium-rich foods.
Correct Answer: C
Rationale: Reducing stress helps lower blood pressure by decreasing sympathetic nervous system activation.
A nurse is reinforcing teaching with a client who is scheduled for a lumbar puncture. Which of the following instructions should the nurse include?
- A. Avoid eating after midnight before the procedure.
- B. Lie flat for 4 to 6 hours after the procedure.
- C. Expect general anesthesia during the procedure.
- D. Avoid drinking fluids for 12 hours before the procedure.
Correct Answer: B
Rationale: Lying flat for 4 to 6 hours after a lumbar puncture prevents cerebrospinal fluid leakage and reduces headache risk.
A nurse is caring for a client who has a new diagnosis of restless legs syndrome. Which of the following findings should the nurse expect?
- A. Leg discomfort
- B. Weight gain
- C. Bradycardia
- D. Hypotension
Correct Answer: A
Rationale: Leg discomfort, especially at night, is a hallmark symptom of restless legs syndrome, prompting movement.