Nokea
The client asks the nurse whether he will need surgery to correct his hiatal hernia. Which reply by the nurse would be most accurate?
- A. Surgery is usually required, although medical treatment is attempted first.'
- B. Hiatal hernia symptoms can usually be successfully managed with diet modifications, medications, and lifestyle changes.'
- C. Surgery is not performed for this type of hernia.'
- D. A minor surgical procedure to reduce the size of the diaphragmatic opening will probably be planned.'
Correct Answer: B
Rationale: Most hiatal hernias are managed effectively with diet, medications, and lifestyle changes, making this the most accurate response.
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Which of the following should the nurse include when preparing a client for magnetic resonance imaging (MRI) to evaluate a ruptured disc?
- A. Informing the client that the procedure is painless.
- B. Taking a thorough history of past surgeries.
- C. Checking for previous complaints of claustrophobia.
- D. Starting an I.V. line at keep-open rate.
Correct Answer: C
Rationale: Checking for claustrophobia is essential, as MRI can be distressing for claustrophobic clients.
The nurse is assessing a client with acute diverticulitis. Which symptom requires immediate reporting to the physician?
- A. Mild left lower quadrant pain.
- B. Temperature of 101°F (38.3°C).
- C. Soft, formed stools.
- D. Nausea without vomiting.
Correct Answer: B
Rationale: A temperature of 101°F (38.3°C) in acute diverticulitis may indicate worsening infection or abscess, requiring immediate reporting. Mild pain, formed stools, and nausea are less urgent unless escalating. CN: Physiological adaptation; CL: Analyze
Regular oral hygiene is essential for the client who has had a stroke. Which of the following nursing measures is not appropriate when providing oral hygiene?
- A. Placing the client on the back with a small pillow under the head.
- B. Keeping portable suctioning equipment at the bedside.
- C. Opening the client's mouth with a padded tongue blade.
- D. Cleaning the client's mouth and teeth with a toothbrush.
Correct Answer: A
Rationale: Placing the client on their back increases the risk of aspiration, especially in stroke patients with impaired swallowing. Suction equipment, padded tongue blades, and toothbrushing are appropriate for safe oral hygiene.
A client with a fracture develops compartment syndrome. Which of the following signs should alert the nurse to impending organ failure?
- A. A condition.
- B. Jaundice.
- C. Generalized edema.
- D. Dark, scanty urine.
Correct Answer: D
Rationale: Dark, scanty urine indicates renal failure, a potential complication of compartment syndrome due to myoglobin release.
Which instructions should the nurse include when developing a teaching plan for a client being discharged from the hospital on anticoagulant therapy after having deep vein thrombosis (DVT)? Select all that apply.
- A. Checking urine for bright blood and a dark smoky color
- B. Daily walking as a good exercise
- C. Using garlic and ginger, which may decrease bleeding time
- D. Performing foot/leg exercises and walking around the airplane cabin on long flights
- E. Prevention as the best treatment for DVT
- F. Avoiding surface bumps because the skin is prone to injury
Correct Answer: A,B,D,F
Rationale: Rationales: A) Monitoring urine for bleeding is essential on anticoagulants. B) Daily walking promotes circulation, preventing DVT recurrence. D) Foot/leg exercises and movement during flights reduce stasis. F) Avoiding bumps prevents bruising/bleeding due to anticoagulant therapy. C) Garlic and ginger may increase bleeding risk, not decrease it. E) Prevention is vague and not a specific instruction.