Nokea
A woman is being seen in the physician's office for a medical complaint. When she is called to see the physician, she goes to the restroom and washes her hands over and over, missing her allotted time with the physician. How should the nurse deal with this woman?
- A. Send her home without seeing the doctor if she is not available when called
- B. Give her advance warning that she will be seeing the physician and tell her that if she needs to wash her hands, she should do so
- C. Interrupt her washing ritual and insist that she see the physician when it is her turn
- D. Give her a choice of seeing the physician or washing her hands
Correct Answer: B
Rationale: Advance warning accommodates possible OCD, allowing hand washing within a timeframe, ensuring she sees the physician. Sending home, interrupting, or forcing choices is less effective.
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The licensed practical nurse (LPN) is assisting the registered nurse in caring for 4 clients. Which client is at greatest risk for the development of deep venous thrombosis?
- A. 25-year-old client with abdominal pain who smokes cigarettes and takes oral contraceptives
- B. 55-year-old ambulatory client with exacerbation of chronic bronchitis and an elevated hematocrit level
- C. 72-year-old client who had coronary stent placement 2 days ago and has an elevated temperature
- D. 80-year-old client who had surgical repair of a fractured hip 4 days ago
Correct Answer: D
Rationale: An 80-year-old post-hip surgery client is at highest DVT risk due to age, immobility, and recent surgery. Smoking and contraceptives , elevated hematocrit , and stent with fever carry risks but are less immediate.
The nurse is reinforcing instructions related to antibiotic eye drop administration to the parent of a 5-year-old with bacterial conjunctivitis. Which instruction is most important?
- A. Discard tissues used to blot excess medication from the eye immediately
- B. Have your child lie down before you instill the eye drops
- C. Use warm, moist compresses to remove crusting on eyelids
- D. Wash hands before and after eye drop instillation
Correct Answer: D
Rationale: Hand washing before and after eye drop administration is most important to prevent infection spread in bacterial conjunctivitis. Discarding tissues , lying down , and using compresses are supportive but secondary to infection control.
The nurse is caring for a client who had a right modified radical mastectomy 4 hours ago. The nurse should place the client in the
- A. high Fowler position with the right arm resting on the bed
- B. supine position with the right arm elevated on several pillows
- C. semi-Fowler position with the right arm elevated on several pillows
- D. supine position with the right arm resting on the bed
Correct Answer: C
Rationale: Semi-Fowler position with the right arm elevated promotes drainage and reduces edema post-mastectomy. High Fowler may strain the incision, and supine without elevation (B, D) increases edema risk.
An adult client in an acute care setting asks the nurse to show him his hospital records. The nurse's response should reflect which understanding?
- A. The client has no right to see his records without a court order.
- B. The client must have the physician's approval before he can see his records.
- C. The client has the right to see his records and to have information explained when necessary.
- D. The client must ask permission to view his records from the medical records department and must appear before a special committee.
Correct Answer: C
Rationale: HIPAA grants clients the right to access their medical records and receive explanations, ensuring transparency. Court orders, physician approval, or committees are not required.
A client diagnosed with cirrhosis is started on lactulose (Cephulac). The main purpose of the drug for this client is to
- A. add dietary fiber
- B. reduce ammonia levels
- C. stimulate peristalsis
- D. control portal hypertension
Correct Answer: B
Rationale: Lactulose blocks the absorption of ammonia from the GI tract and secondarily stimulates bowel elimination.