Nokea
An older, sedentary adult may not respond to emotional or physical stress as well as a younger individual because of:
- A. Left ventricular atrophy.
- B. Irregular heartbeats.
- C. Peripheral vascular occlusion.
- D. Pacemaker placement.
Correct Answer: A
Rationale: Aging leads to left ventricular atrophy, reducing cardiac reserve and impairing the heart's ability to respond to stress, unlike irregular heartbeats or pacemakers.
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The nurse is assisting with a bone marrow aspiration and biopsy. In which order, from first to last, should the nurse complete the following tasks?
- A. Verify the client has signed an informed consent.
- B. Position the client in a side-lying position.
- C. Clean the skin with an antiseptic solution.
- D. Apply ice to the biopsy site.
Correct Answer: C,A,B,D
Rationale: First, the nurse must verify that the client has voluntarily signed a consent form before the procedure begins, and check that the client understands the procedure. The nurse then positions the client in a side-lying, or lateral decubitus, position with the affected side up. Then the nurse should clean the skin site and surrounding area with an antiseptic solution such as Betadine before the health care provider collects the specimen. When the procedure is finished, the nurse must apply ice to the biopsy site to reduce pain.
The nurse is planning care for a client with a fractured humerus in a sling. Which intervention should be included?
- A. Encourage shoulder shrugging exercises.
- B. Apply heat to the fracture site.
- C. Keep the arm in a dependent position.
- D. Restrict all arm movement.
Correct Answer: A
Rationale: Shoulder shrugging exercises maintain mobility and prevent stiffness without stressing the fracture.
The nurse is caring for an older adult in the emergency department with moderate hypothermia. Which of the following actions should the nurse take? Select all that apply.
- A. Apply external heat with a heating blanket to the client's trunk.
- B. Actively rewarm the extremities first, followed by the client's trunk.
- C. Use extracorporeal rewarming methods such as cardiopulmonary bypass or hemodialysis.
- D. Monitor for fluid, electrolyte, and metabolic abnormalities.
- E. Administer ordered medications at spaced longer intervals.
- F. Administer room temperature intravenous (IV) fluids for core rewarming.
Correct Answer: A,D,F
Rationale: Applying heat to the trunk (A), monitoring electrolytes (D), and using room-temperature IV fluids (F) are appropriate for moderate hypothermia. Rewarming extremities first (B) risks core afterdrop, extracorporeal methods (C) are for severe cases, and altering medication intervals (E) lacks evidence.
After knee arthroplasty, the client has a sequential compression device (SCD). The nurse should do which of the following?
- A. Elevate the sequential compression device (SCD) on two pillows.
- B. Change the settings on the SCD to make the client more comfortable.
- C. Use the SCD to remove dressings and bathe the leg.
- D. Discontinue the SCD when the client is ambulatory.
Correct Answer: D
Rationale: The SCD is discontinued when the client is ambulatory, as mobility reduces the risk of thrombosis.
The nurse is caring for a client with a peripherally inserted central catheter (PICC) in the left upper extremity. It would indicate correct nursing care if the nurse
- A. pulsatile flushes each lumen with 0.9% sodium chloride (normal saline) in a 5 mL syringe.
- B. slowly flushes each lumen with 0.9% sodium chloride (normal saline) in a 10 mL syringe.
- C. pulsatile flushes each lumen with sterile water in a 10 mL syringe.
- D. pulsatile flushes each lumen with 0.9% sodium chloride (normal saline) in a 10 mL syringe.
Correct Answer: D
Rationale: PICC lines require pulsatile flushing with 0.9% saline in a 10 mL syringe to maintain patency and prevent occlusion.