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An older adult client with symptoms of osteoarthritis asks the nurse which form of exercise would be most beneficial. Which is the best response by the nurse?
- A. Jogging or running are excellent aerobic exercises.
- B. Tennis or racquetball will increase your muscle strength.
- C. Limit your exercise to just your daily activities.
- D. Swimming is an excellent exercise for you.
Correct Answer: D
Rationale: Swimming is a low-impact aerobic exercise that strengthens muscles, improves cardiovascular fitness, and enhances joint flexibility without putting stress on joints, making it ideal for osteoarthritis.
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A client with acquired immune deficiency syndrome (AIDS) and Pneumocystis jiroveci pneumonia has a CD4+ T cell count of 200 cells/mm³ (20%). The client asks the nurse why they have these recurring massive infections. Which pathophysiologic mechanism should the nurse describe in response to this client's question?
- A. The humoral immune response lacks B cells that form antibodies and opportunistic infections result.
- B. Inadequate numbers of T lymphocytes are available to initiate cellular immunity and macrophages.
- C. Bone marrow suppression of white blood cells causes insufficient cells to phagocytize organisms.
- D. Exposure to multiple environmental infectious agents overburdens the immune system until it fails.
Correct Answer: B
Rationale: Inadequate numbers of CD4+ T cells, due to HIV infection, impair cellular immunity, leading to susceptibility to opportunistic infections like Pneumocystis jiroveci pneumonia.
A client is hospitalized with an inflammatory bowel disease (IBD) exacerbation and is being treated with a corticosteroid. The client develops a rigid abdomen with rebound tenderness. Which action should the nurse take?
- A. Measure capillary glucose level.
- B. Encourage ambulation in the room.
- C. Monitor for bloody diarrheal stools.
- D. Obtain vital sign measurements.
Correct Answer: D
Rationale: Obtaining vital sign measurements is the priority action for a client with a rigid abdomen and rebound tenderness, indicating peritonitis, a serious complication of IBD. Vital signs can reveal signs of infection, inflammation, shock, and organ failure, guiding appropriate interventions and treatments.
The nurse is caring for a client who had an appendectomy 4 hours ago. Which finding requires immediate action by the nurse?
- A. Redness and edema noted at the incision site.
- B. Apical heart rate of 100 to 110 beats/minute.
- C. High-pitched sound heard upon inspiration.
- D. Pain rating of 8 on a scale of 0 to 10.
Correct Answer: C
Rationale: High-pitched sound heard upon inspiration is a sign of stridor, which is a life-threatening emergency that indicates airway obstruction. The nurse should call for help, administer oxygen, and prepare for intubation or tracheostomy.
A patient is admitted to the hospital with symptoms consistent with a right hemisphere stroke. Which neurovascular assessment requires immediate intervention by the nurse?
- A. Pupillary changes to ipsilateral dilation.
- B. Left-sided facial drooping and dysphagia.
- C. Orientation to person and place only.
- D. Unequal bilateral hand grip strengths.
Correct Answer: A
Rationale: Pupillary changes to ipsilateral dilation indicate increased intracranial pressure, which is a life-threatening complication of stroke. The nurse should notify the physician and prepare for emergency measures.
A client has an absolute neutrophil count (ANC) of 500/mm³ (0.5 x 10â¹/L) after completing chemotherapy. Which intervention is most important for the nurse to implement?
- A. Review need for pneumococcal vaccine.
- B. Implement bleeding precautions.
- C. Assess vital signs every 4 hours.
- D. Place the client in protective isolation.
Correct Answer: D
Rationale: Placing the client in protective isolation is the most important intervention to prevent infections, as a low ANC indicates a high risk of bacterial and fungal infections.