Nokea
The charge nurse on a cardiac unit tells you a patient is exhibiting signs of right-sided heart failure. Which of the following would not indicate right-sided heart failure?
- A. Nausea
- B. Anorexia
- C. Rapid weight gain
- D. SOB (shortness of breath)
Correct Answer: D
Rationale: Left sided heart failure exhibits signs of pulmonary compromise (SOB).
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A client with Parkinson's disease complains of 'choking' when he swallows. Which intervention will improve the client's ability to swallow?
- A. Withholding liquids until after meals
- B. Providing semi-liquids when possible
- C. Providing a full liquid diet
- D. Offering small, more frequent meals
Correct Answer: B
Rationale: Semi-liquids are easier to swallow for Parkinson's patients with dysphagia. Withholding liquids risks dehydration. Full liquid diets may be too thin. Small meals help nutrition but not swallowing.
A 67 year-old client with non-insulin dependent diabetes should be instructed to contact the out-patient clinic immediately if the following findings are present
- A. Temperature of 99.5 degrees Fahrenheit with painful urination
- B. An open, reddened wound on the heel
- C. Insomnia and daytime fatigue
- D. Nausea with 2 episodes of vomiting
Correct Answer: B
Rationale: An open, reddened wound on the heel. When signs of trauma and/or infection occur in their feet, elderly clients who have diabetes and/or vascular disease should seek health care quickly and continue treatment until the problem is resolved. Without treatment, serious infection, gangrene, limb loss, and death may result.
The nurse is repairing new prescriptions from the health care provider. Which prescription would require further clarification?
- A. Atorvastatin for hyperlipidemia in a client with angina pectoris
- B. Bupropion for smoking cessation in a client with emphysema
- C. Cyclobenzaprine for muscle spasms in a client with hepatitis
- D. Metronidazole for trichomoniasis in a client with Crohn disease
Correct Answer: C
Rationale: Cyclobenzaprine is contraindicated in hepatic impairment due to hepatitis, as it is metabolized by the liver, requiring clarification. Other prescriptions (A, B, D) are appropriate for the conditions.
A client is scheduled for a myelogram. Which of the following medications orders should be questioned?
- A. Ampicillin (Pencipen) $250 \mathrm{mg} \mathrm{PO} \mathrm{q} 6$ hours
- B. Motrin (Ibuprofen) $400 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours PRN for headache
- C. Secobarbital (Seconal) $50 \mathrm{mg}$ HS PRN for sleep
- D. Propoxyphene (Darvon) $65 \mathrm{mg} \mathrm{PO} \mathrm{q} 4$ hours for pain
Correct Answer: B
Rationale: Ibuprofen (Motrin) has anticoagulant properties, increasing bleeding risk during a myelogram, a procedure involving spinal puncture. Other medications are safer.
The nurse is preparing to give a heparin injection to a client who is severely malnourished and has minimal adipose tissue. Which method of injection would be appropriate for this client?
- A. EX12_Q49_1.PNG
- B. EX12_Q49_2.PNG
- C. EX12_Q49_3.PNG
- D. EX12_Q49_4.PNG
Correct Answer: C
Rationale: For a malnourished client with minimal adipose tissue, heparin should be injected at a 90-degree angle using a 25-gauge needle to ensure subcutaneous delivery without hitting muscle.