Nokea
A nurse is working on discharging a client when the client expresses interest in becoming an organ donor. Which action by the nurse best facilitates the organ donation process?
- A. Providing the client with information about how to register as an organ donor.
- B. Advising the client to sign an organ donor card and carry it with them at all times.
- C. Scheduling the client for immediate organ donation surgery upon expressing interest.
- D. Assisting the client in completing advance directives specifying their wish for organ donation.
Correct Answer: A
Rationale: Providing information on how to register as an organ donor is the most effective way to facilitate the process.
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The following scenario applies to the next 1 items
The nurse in the obstetrics department is caring for a 29-year-old primigravida client.
Item 1 of 1
History and Physical
2300: Client is a primigravida at 33 weeks gestation, who awoke to moderate bright red vaginal bleeding. She reports noticing light spotting earlier in the day, which she dismissed as benign. She denies abdominal pain, cramping, or contractions. Her pregnancy has been uncomplicated until recently. She reports increased fetal movement over the last 48 hours. One week ago, she presented to the ED with fever, fatigue, and body aches, and was diagnosed with influenza A. She was treated supportively and discharged home with hydration instructions. Over the past 24 hours, she has experienced nasal congestion and fatigue.
Four days ago, a transabdominal ultrasound showed:
• Fetus in cephalic position
• Normal amniotic fluid volume
Exam findings
• Abdomen: Soft, non-tender
• No uterine contractions noted on palpation
• Moderate amount of dried bright red blood was seen on the undergarments
• 1+ pedal edema
• Peripheral pulses 2+
•
Diagnostics
2342: Fetal Heart Rate (FHR): 144 bpm, moderate variability, no decelerations
Vital Signs
• Temperature: 99.5°F (37.5°C)
• HR 88 bpm
• BP 137/78 mmHg
• RR 18/min
• Pulse oximetry 98% on room air
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress.
- A. Request a prescription for indomethacin, Prepare the client for a transvaginal ultrasound, Place the client in the lithotomy position for a manual cervical exam, Establish a peripheral vascular access device, Place the client in a room with monitored negative airflow
- B. Placental abruption, Preeclampsia, Placenta previa, Influenza recurrence
- C. Fetal heart rate pattern, Pedal edema, Amount and color of vaginal bleeding, Temperature, Nasal congestion and fatigue level
Correct Answer: C (placenta previa), A (prepare for transvaginal ultrasound, establish peripheral vascular access device), C (fetal heart rate pattern, amount and color of vaginal bleeding)
Rationale: Moderate bright red vaginal bleeding without pain at 33 weeks suggests placenta previa. Transvaginal ultrasound confirms the diagnosis, peripheral access prepares for potential intervention, and monitoring fetal heart rate and bleeding assesses progress.
The nurse is planning a staff educational conference about indwelling urinary catheters. Which of the following information should the nurse include?
- A. Sterile gloves should be used to perform urinary catheter care.
- B. Urinary specimens may be collected from a catheter bag.
- C. You may irrigate a catheter with warm water for poor outflow.
- D. Daily use of soap and water should be used around the urinary meatus.
Correct Answer: D
Rationale: Daily soap and water cleaning around the urinary meatus prevents infection. Sterile gloves are not required, specimens from catheter bags are unreliable, and irrigation requires a prescription.
The nurse in the emergency department (ED) is caring for a 10-year-old client.
Item 3 of 5
Nurses' Notes
1322: 10-year-old client and his parents report an 8-day history of a brownish-raised lesion over the back of his left leg. The parents report that the size of the rash has increased. The parents report returning from a one-week camping trip three weeks ago. The parents deny efficacy with over-the-counter antihistamine creams. The client's parents deny that the child has had a fever but has felt 'warm' occasionally and endorsed an intermittent headache. They report an area of firmness in the child's groin. On assessment, there was an erythematous, raised, nonpainful, oval patch on the back of his left leg. This was an enlargement of an inguinal lymph node. The child is alert and fully oriented and denies any pain. Peripheral pulses palpable 2+. No cyanosis or edema in the extremities. Lung sounds clear bilaterally. The parents report that the child did not receive the seasonal influenza vaccine. He currently takes a multivitamin for iron deficiency anemia and was hospitalized one year ago for an appendectomy. The parents state that the child’s sibling had influenza one month ago. Vital signs: T 98.8°F (37.1°C); HR 78 beats/min; RR 16 breaths/min; BP 110/76 mm Hg. SpO2 97% on room air.
The client is demonstrating manifestations consistent with
- A. influenza
- B. Rocky Mountain spotted fever
- C. Lyme disease
- D. None of the above
Correct Answer: C
Rationale: The bullseye rash, lymphadenopathy, and camping history are consistent with Lyme disease.
The nurse is reviewing a client's list of medications who has cystic fibrosis. The nurse anticipates a prescription for which medication?
- A. Multivitamin
- B. Aspirin
- C. Warfarin
- D. Simvastatin
- E. Salmeterol
Correct Answer: A, E
Rationale: Multivitamins address malabsorption, and salmeterol helps manage airway obstruction in cystic fibrosis.
The nurse is reviewing newly prescribed medications for assigned clients. Which of the following prescribed medications should the nurse question?
- A. Levothyroxine for a client with a myxedema coma
- B. Hydrochlorothiazide for a client with hyperparathyroidism
- C. Hydrocortisone for a client with adrenal insufficiency
- D. Regular insulin for a client with diabetic ketoacidosis
Correct Answer: B
Rationale: Hydrochlorothiazide can worsen hypercalcemia in hyperparathyroidism and should be questioned.