Nokea
An obese diabetic client complains of bilateral leg aching. His physician has referred him to cardiac rehabilitation to start an exercise program. Which of the following activities is most helpful for the client?
- A. Interval training on the stationary bicycle.
- B. Interval training on the treadmill.
- C. Interval training on a commercial ski machine.
- D. Interval training on the stair climber.
Correct Answer: A
Rationale: Stationary cycling is low-impact, suitable for an obese diabetic client, minimizing joint stress while improving cardiovascular health.
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A client has started taking amiodarone (Cordarone). The nurse should inform the client that periodic laboratory tests will be done to monitor the client's:
- A. Hemoglobin.
- B. Liver enzymes.
- C. Creatine kinase (CK) concentration.
- D. Renal function.
Correct Answer: B
Rationale: Amiodarone can cause hepatotoxicity, so periodic monitoring of liver enzymes is necessary to detect potential liver damage.
A client has been hospitalized with heart failure. He is receiving digoxin (Lanoxin) and furosemide (Lasix) intravenously. He tells the nurse that he hears a continuous ringing in his ears and that he has never had this problem before. What is the appropriate action for the nurse to take at this time?
- A. Obtain a digoxin level to check for toxicity
- B. Note the observation in the chart and plan to reassess in 2 hours
- C. Ask the client if he has been taking aspirin in addition to his other medications
- D. Discontinue the furosemide and notify the physician
Correct Answer: A
Rationale: Ringing in the ears (tinnitus) is a sign of digoxin toxicity, requiring immediate checking of digoxin levels. Aspirin is less likely to cause this, and discontinuing furosemide or delaying action is inappropriate.
For which of the following should the nurse closely assess a client who is reversing from halothane (Fluothane) general anesthesia and receiving clindamycin (Cleocin)?
- A. Tachycardia
- B. Respiratory depression
- C. Hypotension
- D. Renal failure
Correct Answer: B
Rationale: Halothane, a general anesthetic, can cause respiratory depression during recovery, which is a critical condition to monitor. Clindamycin is not strongly associated with these other effects in this context.
A client with emphysema is receiving continuous oxygen therapy. Depressed ventilation is likely to occur unless the nurse ensures that the oxygen is administered in which of the following ways?
- A. Cooled.
- B. Humidified.
- C. At a low flow rate.
- D. Through nasal cannula.
Correct Answer: C
Rationale: Low flow rate oxygen prevents CO2 retention in emphysema clients, reducing the risk of depressed ventilation.
A client with a paranoid personality disorder sees some clients laughing during a group activity and asks the nurse, 'Why are they laughing at me? I bet they're making fun of me.' Which of the following responses by the nurse is most appropriate?
- A. You shouldn't let yourself get so upset
- B. Don't worry about them. They don't mean any harm
- C. Look. They seem to be having fun
- D. They're laughing at a joke John told. They aren't laughing at you
Correct Answer: D
Rationale: Providing a factual explanation that the laughter is due to a joke addresses the client's paranoia directly and reassuringly, reducing misinterpretation. Other responses dismiss or minimize the client's feelings.