Nokea
A woman who works as a data entry clerk is concerned as to how recent diagnosis of Raynaud's syndrome is going to affect her job performance. Which instruction should the nurse provide this client?
- A. Use a space heater to keep the workspace warm
- B. Keep hands elevated above the heart to prevent swelling.
- C. Wear tight gloves during work to avoid temperature fluctuations.
- D. Take frequent breaks to improve circulation in the hands.
Correct Answer: A
Rationale: Keeping the hands warm helps prevent vasospasms, which are characteristic of Raynaud's syndrome.
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Which of the following is an example of ductus dependent systemic circulation?
- A. Severe Ebstein's anomaly
- B. Pulmonary atresia
- C. Tricuspid atresia
- D. Interruption of aortic arch
Correct Answer: D
Rationale: Interruption of aortic arch is ductus dependent as it relies on the ductus arteriosus for systemic blood flow.
A client with Cushing's syndrome is recovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse?
- A. Irregular apical pulse
- B. Purple marks on the skin of the abdomen
- C. Quarter size blood spot on dressing
- D. Pitting ankle edema
Correct Answer: A
Rationale: An irregular apical pulse could indicate cardiac complications, which are a risk in clients with Cushing's syndrome due to fluid and electrolyte imbalances.
Which patient could require feeding by gavage?
- A. Infant with congestive heart failure (CHF)
- B. Toddler with repair of transposition of the great vessels
- C. Toddler with Kawasaki disease (KD) in the acute phase
- D. School-age child with rheumatic fever (RF) and chorea
Correct Answer: B
Rationale: Feeding by gavage may be required if the child is unable to feed orally without increased cardiac demand, as might be seen after surgical repair of transposition of the great vessels.
A male client with heart failure (HF) calls the clinic and reports that he cannot put his shoes on because they are too tight. Which additional information should the nurse obtain?
- A. What time did he take his last medications?
- B. Has his weight changed in the last several days?
- C. Is he still able to tighten his belt buckle?
- D. How many hours did he sleep last night?
Correct Answer: B
Rationale: Weight gain is a key indicator of fluid retention in heart failure, which can exacerbate symptoms.
A fair-skinned female client who is an avid runner is diagnosed with malignant melanoma, located on the lateral surface of the lower leg. After wide margin resection, the nurse provides discharge teaching. It is most important for the nurse to emphasize the need to observe for changes in which characteristic?
- A. Elasticity of the skin
- B. Appearance of any moles
- C. Muscle aches and pains
- D. Pigmentation of the skin
Correct Answer: B
Rationale: Monitoring for changes in moles is critical for early detection of new or recurrent melanoma, which is essential for timely intervention.