Nokea
Bed rest is prescribed for a client with pneumonia during the acute phase of the illness. The nurse should determine the effectiveness of bed rest by assessing the client's:
- A. Decreased cellular demand for oxygen.
- B. Reduced episodes of coughing.
- C. Diminished pain when breathing deeply.
- D. Ability to expectorate secretions more easily.
Correct Answer: A
Rationale: Bed rest reduces oxygen demand by decreasing metabolic rate, aiding recovery in pneumonia. Reduced coughing, diminished pain, and easier expectoration are secondary benefits but not the primary measure of bed rest effectiveness.
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The family members caring for a 72-year-old client who is near death from colon cancer are concerned about dehydration. What should the nurse tell them about dehydration at end of life?
- A. The physician will make the decision regarding hydration therapy.
- B. Dehydration may prolong the dying process.
- C. Hydration is used only in extreme situations of dehydration.
- D. Dehydration is expected during the dying process.
Correct Answer: D
Rationale: Dehydration is a natural part of the dying process and is often not treated aggressively in hospice care, as it may not cause discomfort and can reduce symptoms like edema.
A client is admitted to the emergency department with a full thickness burn to his right arm. Upon assessment, the arm is edema, the agent is mottled, and radial pulse is now absent. The client states that the pain is 8 on a scale of 1 to 10 . The nurse should:
- A. Administer morphine sulfate I.V. push for the severe pain.
- B. Call the physician to report the loss of the radial pulse.
- C. Continue to assess the arm every hour for any additional changes.
- D. Instruct the client to exercise his fingers and wrist.
Correct Answer: B
Rationale: The absence of the radial pulse indicates potential compartment syndrome or vascular compromise, which is a medical emergency requiring immediate physician notification to prevent tissue necrosis.
The best method to remove cerumen from a client's ear involves:
- A. Inserting a cotton-tipped applicator into the external canal.
- B. Irrigating the ear gently.
- C. Using aural suction.
- D. Using a cerumen curette.
Correct Answer: B
Rationale: Gentle irrigation with warm water or saline is the safest and most effective method to remove cerumen, avoiding trauma to the ear canal or eardrum.
A client is in balanced suspension traction using a half-ring Thomas splint with a Pearson attachment that suspends the lower extremity and applies direct skeletal traction for a hip fracture. Which of the following nursing assessments would not be appropriate?
- A. Greater trochanter skin checks.
- B. Pin site inspection.
- C. Neurovascular checks proximal to the splint.
- D. Foot movement evaluation.
Correct Answer: C
Rationale: Neurovascular checks proximal to the splint are less relevant, as distal checks assess circulation and nerve function affected by the fracture and traction.
Pseudoephedrine (Sudafed) has been ordered as a nasal decongestant. Which of the following is a possible adverse effect of this drug?
- A. Constipation.
- B. Bradycardia.
- C. Diplopia.
- D. Restlessness.
Correct Answer: D
Rationale: Pseudoephedrine is a sympathomimetic that can cause central nervous system stimulation, leading to restlessness. Constipation, bradycardia, and diplopia are not common adverse effects of this medication.