Nokea
A postmenopausal client is scheduled for a bone-density scan. To plan for the client's test, what should the nurse communicate to the client?
- A. Request that the client remove all metal objects on the day of the scan.
- B. Instruct the client to consume foods and beverages with a high content of calcium for 2 days before the test.
- C. Inform the client that she will need to ingest 600 mg of calcium gluconate by mouth for 2 weeks before the test.
- D. Tell the client that she should report any significant pain to her physician at least 2 days before the test.
Correct Answer: A
Rationale: Metal objects can interfere with the bone-density scan, so they must be removed. Calcium intake or pain reporting is not required for the test.
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A short time after cataract surgery, the client complains of nausea. The nurse should first:
- A. Instruct the client to take a few deep breaths until the nausea subsides.
- B. Explain that this is a common feeling that will pass quickly.
- C. Tell the client to call the nurse promptly if vomiting occurs.
- D. Administer an antiemetic, as ordered.
Correct Answer: D
Rationale: Nausea after cataract surgery can indicate increased intraocular pressure or other complications. Administering an antiemetic as ordered is the priority to prevent vomiting, which could increase intraocular pressure and cause complications.
The nurse notes a client's preoperative hemoglobin is 9.8 g/dL. What is the priority nursing action?
- A. Administer iron supplements as ordered.
- B. Notify the surgeon of the result.
- C. Encourage a high-protein diet.
- D. Document the finding and continue preparations.
Correct Answer: B
Rationale: A hemoglobin of 9.8 g/dL indicates anemia, which increases surgical risks. Notifying the surgeon ensures evaluation and possible intervention before proceeding.
A client has undergone an amputation of several toes and a femoral-popliteal bypass. The nurse should teach the client that after surgery which of the following leg positions is contraindicated for her while sitting in a chair?
- A. Crossing the legs
- B. Elevating the legs
- C. Flexing the ankles
- D. Extending the knees
Correct Answer: A
Rationale: Crossing the legs is contraindicated post-femoral-popliteal bypass and toe amputation, as it compresses blood vessels, impairing circulation and increasing the risk of graft occlusion or ischemia. Elevating legs, flexing ankles, and extending knees are generally acceptable unless otherwise specified.
When the nurse is conducting a preoperative interview with a client who is having a vaginal hysterectomy, the client states that she forgot to tell her doctor that she had a total hip replacement 3 years ago. The nurse communicates this information to the perioperative nurse because:
- A. The prosthesis may cause a problem with the electrosurgical unit used to control bleeding.
- B. The client should not have her hip externally rotated when she is positioned for the procedure.
- C. The perioperative nurse can inform the rest of the team about the total hip replacement.
- D. There is not enough time to notify the surgeon and note this finding on the history and physical information before the procedure.
Correct Answer: A
Rationale: A hip prosthesis can conduct electricity from an electrosurgical unit, risking burns or complications. Communicating this ensures precautions are taken during surgery.
During rescue breathing in cardiopulmonary resuscitation (CPR), the victim will exhale by:
- A. Normal relaxation of the chest.
- B. Gentle pressure of the rescuer's hand on the upper chest.
- C. The pressure of cardiac compressions.
- D. Turning the head to the side.
Correct Answer: A
Rationale: Exhalation during CPR occurs naturally due to chest relaxation after the rescuer delivers a breath, allowing air to exit the lungs.