Nokea
Based on clinical findings, the physician suspects that a 65-year-old client has kidney disease and has ordered a blood-urea-nitrogen (BUN) test. Which of the following results is within normal limits?
- A. 5 mg/dL
- B. 15 mg/dL
- C. 40 mg/dL
- D. 100 mg/dL
Correct Answer: B
Rationale: Normal BUN is 7-20 mg/dL, so 15 mg/dL (B) is within range. Other values (A, C, D) are too low or high.
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The nurse is preparing to discharge a client following a laparoscopic cholecystectomy. The nurse should:
- A. Tell the client to avoid a tub bath for 48 hours
- B. Tell the client to expect clay-colored stools
- C. Tell the client that she can expect lower abdominal pain for the next week
- D. Tell the client to report pain in the back or shoulders
Correct Answer: D
Rationale: Pain in the back or shoulders post-laparoscopic cholecystectomy may indicate referred pain from residual CO2 or complications, requiring prompt reporting.
How many hours of activity per day are necessary to prevent disuse syndrome with muscle atrophy and joint contracture?
- A. 6 hours
- B. 4 hours
- C. 2 hours
- D. 1 hour
Correct Answer: C
Rationale: Approximately 2 hours of activity daily (C), including range-of-motion exercises or ambulation, helps prevent disuse syndrome, muscle atrophy, and joint contractures in immobilized clients.
The nurse is caring for a client with scalding burns across the face, neck, upper half of the anterior chest, and entire right arm. Using the rule of nines, estimate the percentage of body burned.
- A. 18%
- B. 23%
- C. 32%
- D. 36%
Correct Answer: B
Rationale: Rule of nines: face/neck (4.5% head anterior), upper half anterior chest (4.5% anterior torso/2 = 2.25%), right arm (9%) = 4.5 + 2.25 + 9 = 23%.
During the change of shift, the oncoming nurse notes a discrepancy in the number of percocette listed and the number present in the narcotic drawer. The nurse's first action should be to:
- A. Notify the hospital pharmacist
- B. Notify the nursing supervisor
- C. Notify the Board of Nursing
- D. Notify the director of nursing
Correct Answer: B
Rationale: A narcotic discrepancy requires reporting to the supervisor for investigation.
The blood alcohol concentration of a client admitted following a motor vehicle accident is 460 mg/dL. The nurse should give priority to monitoring the client for:
- A. Loss of coordination
- B. Respiratory depression
- C. Visual hallucinations
- D. Tachycardia
Correct Answer: B
Rationale: A blood alcohol concentration of 460 mg/dL (0.46%) is life-threatening, with respiratory depression being the priority due to its potential to cause death.