Nokea
Which of the following signs should the nurse be aware of on a patient who is taking prednisone?
Melena
- A. Hypoglycemia
- B. Hypekalemia
- C. Low platelet counts
Correct Answer: A
Rationale: Prednisone can cause gastrointestinal irritation, leading to melena, a sign of bleeding.
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After a painful exacerbation of rheumatoid arthritis, a patient is to begin a walking and exercise program.
An appropriate outcome would be that the patient:
- A. Avoids exercising when there is some discomfort.
- B. Is pain free while engaging in the activity program.
- C. Walks and exercise even when the pain is severe.
- D. Exercise unless the discomfort becomes too great.
Correct Answer: D
Rationale: Exercising until discomfort becomes too great balances activity with joint protection, promoting safe participation.
If a patient comes into facility with muscle weakness, where should you focus your physical assessment?
If a patient comes into facility with muscle weakness, where should you focus your physical assessment?
- A. Muscle tone
- B. Muscle strength
- C. ROM
- D. Sensory function
Correct Answer: B
Rationale: Muscle strength assessment directly evaluates the extent and distribution of weakness.
Which of the following clients is at greatest risk for postpartal hemorrhage?
- A. A gravida 1 para 1 with an uncomplicated delivery of a 7-pound infant
- B. A gravida 1 para 0 with a history of polycystic ovarian disease
- C. A gravida 2 para 2 with a history of low birth weight infants
- D. A gravida 4 para 3 with a Caesarean section
Correct Answer: D
Rationale: A gravida 4 para 3 with a Caesarean section is at higher risk for postpartal hemorrhage due to multiparity and surgical delivery, which can lead to uterine atony and increased bleeding risk.
The client's blood gas values are: pH=7.35; CO2=60; HCO3=34; and pO2=60. The nurse correctly interprets these to indicate that the client is in which state?
- A. Compensated respiratory acidosis
- B. Partly compensated metabolic alkalosis
- C. Metabolic alkalosis
- D. Metabolic acidosis
Correct Answer: A
Rationale: Normal pH with elevated CO2 and HCO3 indicates compensated respiratory acidosis, where kidneys retain bicarbonate to balance chronic CO2 retention.
The nurse should explain to a client that tolbutamide (Orinase) is effective for diabetics who
- A. can no longer produce any insulin.
- B. produce minimal amounts of insulin.
- C. are unable to administer their injections.
- D. have a sustained decreased blood glucose.
Correct Answer: B
Rationale: Tolbutamide, an oral hypoglycemic, is effective for type 2 diabetes patients who produce minimal insulin, stimulating insulin release. Type 1 diabetics (A) produce no insulin, injection inability (C) is irrelevant, and low blood glucose (D) is not an indication for tolbutamide.