Nokea
Following cardiac bypass surgery, the client has been referred to a cardiac rehabilitation exercise program. The client is a diabetic and has bilateral leg discomfort with walking. The nurse should advise the client to exercise using a stationary bicycle and intermittent training because of the client's:
- A. Diabetic neuropathy
- B. Muscle atrophy
- C. Raynaud's disease
- D. Transient ischemic attacks
Correct Answer: A
Rationale: Diabetic neuropathy likely causes the client's leg discomfort, making low-impact, intermittent stationary cycling suitable to avoid exacerbating symptoms. Other conditions are less likely causes.
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To protect a client who has received tissue plasminogen activator (t-PA, or Activase) therapy, the nurse should:
- A. Use the radial artery to obtain blood gas samples.
- B. Maintain arterial pressure for 10 seconds.
- C. Administer I.M. injections.
- D. Encourage physical activity.
Correct Answer: B
Rationale: Maintaining pressure on arterial puncture sites for 10 seconds minimizes bleeding risk, critical after t-PA due to its thrombolytic effects.
You are the supervising nurse in a physical rehabilitation center that has the philosophy that clients have the need to cope with their disabilities and its limitations are the result of a discrepancy between the client's abilities and the limitations of the physical and social environment within which the client lives. Which model of disability is this philosophy based on?
- A. Orem's Self Care Model
- B. Nagis Model
- C. A cognitive model of disability
- D. A biomedical model of disability
Correct Answer: C
Rationale: This philosophy aligns with the cognitive model of disability, which emphasizes the interaction between an individual's abilities and environmental barriers, focusing on adaptation and coping strategies.
What are the nursing implications associated with administering blood and blood products to a client who has a blood type of B negative?
- A. The nurse must be knowledgeable about the fact that this client has A and B agglutinins and lacks the Rh factor
- B. The nurse must be knowledgeable about the fact that this client has B and O agglutinins and lacks the Rh factor
- C. The nurse must be knowledgeable about the fact that this client has B agglutinins and lacks the Rh factor
- D. The nurse must be knowledgeable about the fact that this client has A agglutinins and lacks the Rh factor
Correct Answer: C
Rationale: B negative blood type has anti-A agglutinins (antibodies against A antigen) and lacks the Rh factor, requiring careful matching to avoid transfusion reactions.
The nurse is ready to administer a partial fill of imipenem-cilastatin (Primaxin) in the I.V. pump when a full partial fill bag of imipenem-cilastatin is found hanging at the client's bedside. Which of the following is not appropriate to do by the nurse when recognizing that the previous dose was not administered 8 hours ago to the client with pneumonia?
- A. Discard the full partial fill of imipenem-cilastatin found hanging at the client's bedside.
- B. Check the identifying information of the full partial fill of imipenem-cilastatin found hanging at the client's bedside.
- C. Follow up on the legal documentation of the client's previous administration of imipenem-cilastatin.
- D. Administer the new partial fill of imipenem-cilastatin.
Correct Answer: A
Rationale: Discarding the medication without investigation is inappropriate; the nurse should verify, document, and address the error appropriately.
A college student is asking the nurse about his grandfather, who just received a diagnosis of Huntington's disease. The student wants to know if he will have the disease, too. What should the nurse tell the student? Select all that apply.
- A. Huntington's disease affects men more than women.'
- B. Huntington's disease is an autosomal dominant disease.'
- C. Huntington's disease does not skip a generation.'
- D. Huntington's disease is a treatable disease.'
- E. There is a 75% chance you will have the disease.'
Correct Answer: B,C
Rationale: Huntington's disease is an autosomal dominant disorder, meaning a 50% chance of inheritance if one parent is affected, and it typically does not skip generations. It affects men and women equally, is not treatable (only symptom management is available), and the risk is not 75% but 50%.