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In caring for a patient with neutropenia, what tasks can be delegated to the nursing assistant? (Choose all that apply.)
- A. Take vital signs every 4 hours.
- B. Report temperature elevation >100.4° F.
- C. Assess for sore throat,cough or burning with urination.
- D. Gather the supplies to prepare the room for protective isolation.
Correct Answer: B
Rationale: Tasks such as taking vital signs, reporting fever, and preparing the room for isolation are within the scope of a nursing assistant, while assessing for specific symptoms requires more advanced clinical skills.
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Stephen Douglas has been in an automobile accident. The most effective IV solution for a patient having hypovolemic shock would be:
- A. hypertonic.
- B. isotonic.
- C. hypotonic.
- D. colloids.
Correct Answer: B
Rationale: Hypertonic IV fluids would be used to draw fluid off tissue in edematous situations such as third spacing. Isotonic solutions are used to increase intravascular volume, to increase perfusion of vital organs. Hypotonic fluids are used to rehydrate tissue in those with severe, or prolonged fluid deprivation. Colloids increase tonicity of intravascular fluids, pulling water into the vascular system from tissue.
A student nurse arrives on the unit and asks you what the rationale for treatment of withdrawal is. What is the best response?
- A. To protect the patient while the body removes the drug from the patient's bloodstream.
- B. To protect the patient from relapsing during withdrawal.
- C. To treat the patient's psychological dependency on the substance.
- D. To treat the symptoms of withdrawal while the body removes the substance from the patient's bloodstream.
Correct Answer: D
Rationale: Treating withdrawal symptoms supports physiological stability as the body clears the substance.
Following treatment with fluoxetine, a selective serotonin reuptake inhibitor for depression, Mary hardly sleeps, is hyperactive, easily distracted, and appears elated. You would expect her physician to
- A. Continue the selective serotonin reuptake inhibitor.
- B. Start a mood stabilizer.
- C. Switch to a tricyclic antidepressant.
- D. Add a monoamine oxidase inhibitor.
Correct Answer: B
Rationale: Mood stabilizers are used to treat symptoms of mania or hypomania associated with bipolar disorder.
Which of the following imbalances should the nurse check for in a pregnant client with hypertension and cardiac dysrhythmias?
- A. Metabolic acidosis
- B. Hypomagnesemia
- C. Hypernatremia
- D. Hypercalcemia
Correct Answer: B
Rationale: Hypomagnesemia is commonly associated with pregnancy-induced hypertension and can contribute to cardiac dysrhythmias. Magnesium plays a critical role in neuromuscular function and electrolyte balance.
During an assessment, a client with a long history of smoking and suspected laryngeal cancer will most likely report which early manifestation?
- A. Dysphagia
- B. Hoarseness
- C. Dyspnea
- D. Weight loss
Correct Answer: B
Rationale: The correct answer is B: Hoarseness. Hoarseness is a common early manifestation of laryngeal cancer due to vocal cord involvement. Smoking is a major risk factor for laryngeal cancer. Dysphagia (choice A) is more commonly associated with esophageal cancer. Dyspnea (choice C) is usually a late manifestation of laryngeal cancer when it causes airway obstruction. Weight loss (choice D) may occur later in the disease progression but is not typically an early sign. Thus, hoarseness is the most likely early manifestation due to its direct connection to the vocal cords and smoking history.