Nokea
A Schilling test is ordered for a female client who has pernicious anemia. It is to run from 8:00 A.M. to 8:00 A.M. the following day. How should the nurse plan care for this client?
- A. Leave the urine container with the client at 8:00 A.M. Instruct her to collect all urine until 8:00 A.M. tomorrow. Pick up container at 8:00 A.M.
- B. Have the client empty her bladder at 8:00 A.M., and send this specimen to the lab. Instruct the client to collect all urine until 8:00 A.M. tomorrow.
- C. At 8:00 A.M., ask the client to empty her bladder. Put this specimen in the container and instruct the client to keep all urine until 8:00 A.M. tomorrow. Have her empty her bladder at 8:00 A.M. and discard the specimen.
- D. Have the client empty her bladder at 8:00 A.M. and discard. Instruct the client to collect all urine. At 8:00 A.M. tomorrow, have the client void, and collect this specimen.
Correct Answer: D
Rationale: The Schilling test requires a 24-hour urine collection starting after discarding the first void at 8:00 A.M. and including the final void at 8:00 A.M. the next day to measure B12 absorption accurately.
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A 34-year-old multipara comes to the prenatal clinic during her fifth month of pregnancy. The client complains to the nurse that her breasts are sensitive and sore.
Which of the following suggestions by the nurse is BEST?
- A. Apply warm compresses to your breasts and take two aspirin as needed.
- B. Massage your breasts with lotion and wear loose-fitting clothing.
- C. Apply cold compresses to your breasts and wear a well-fitting, supportive bra.
- D. Take a diuretic once a day and avoid touching your breasts.
Correct Answer: C
Rationale: Strategy: 'BEST' indicates priority question. All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) would increase circulation and increase discomfort, should avoid taking medications (2) not effective in decreasing discomfort (3) correct-during pregnancy there is an increase in lactiferous ducts and lobule-alveolar tissue (4) medications are to be avoided during pregnancy
A spansule is ordered twice a day for a client in the outpatient clinic. What should the nurse teach the client about taking a spansule?
- A. Take the spansule before breakfast and dinner.
- B. If the spansule is difficult to swallow, open it up and put the contents in food.
- C. Spansules should be taken at 12-hour intervals.
- D. Spansules can safely be cut for partial doses.
Correct Answer: C
Rationale: Spansules are time-release capsules, requiring 12-hour intervals for consistent drug release. Opening, cutting, or meal-based timing disrupts their mechanism.
A patient is admitted to the surgical unit with a diagnosis of rule out inTest inal obstruction.
- A. In which position should the nurse place the patient during insertion of a Salem sump NG tube?
- B. Head of bed elevated 30°-45°.
- C. Head of bed elevated 60°-90°.
- D. Side-lying with head elevated 15°.
- E. Lying flat with head turned to the left side.
Correct Answer: B
Rationale: Elevating the head of the bed to 60°-90° facilitates swallowing and movement of the NG tube through the gastroinTest inal tract, reducing the risk of aspiration and improving patient comfort during insertion. Other positions do not optimize swallowing or tube passage as effectively.
Which of the following assessment findings would indicate to the nurse the need for more sedation in a client who is withdrawing from alcohol dependence?
- A. Steadily increasing vital signs.
- B. Mild tremors and irritability.
- C. Decreased respirations and disorientation.
- D. Stomach distress and inability to sleep.
Correct Answer: A
Rationale: Steadily increasing vital signs (e.g., heart rate, blood pressure) indicate progression toward delirium tremens, a life-threatening complication of alcohol withdrawal, necessitating additional sedation. Mild tremors, decreased respirations, or gastroinTest inal symptoms are expected or contraindicate more sedation.
A client with pneumonia.
Which of the following nursing observations would indicate a therapeutic response to the treatment?
- A. Oral temperature of 101°F (38.3°C), increased chest pain with nonproductive cough.
- B. Cough, productive of thick green sputum, client reports feeling tired.
- C. Respirations at 20 with no complaints of dyspnea, moderate amount of thin white sputum.
- D. White cell count of 10,000 mm³, urine output at 40 cc per hour, decreasing amount of sputum.
Correct Answer: C
Rationale: Strategy: Determine which answer choice indicates an improved respiratory status. (1) validates the continued presence of the infection (2) validates the continued presence of the infection (3) correct-sputum characteristics indicate a decrease in the pneumonia; is supported by respiratory status (4) does not substantiate the status of the infection