Nokea
The client with peripheral vascular disease has been prescribed diltiazem (Cardizem). The nurse should determine the effectiveness of this medication by assessing the client for:
- A. Relief of anxiety
- B. Sedation
- C. Vasoconstriction
- D. Vasodilation
Correct Answer: D
Rationale: Diltiazem, a calcium channel blocker, promotes vasodilation in PVD, improving blood flow and reducing claudication symptoms. The nurse assesses for vasodilation (e.g., reduced pain, warmer extremities). It does not primarily relieve anxiety, cause sedation, or promote vasoconstriction.
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Following abdominal surgery, a client refuses to deep breathe and cough every 2 hours as ordered. The nurse should do which of the following first?
- A. Ask the client's wife to assist with the daily fluid intake to at least 2,500 mL.
- B. Respect the client's wishes and turn the client from side-to-side more frequently.
- C. Assess the client's reasons for refusing to deep breathe and cough.
- D. Explain the risks of not expanding the lungs and why the exercise is important.
Correct Answer: C
Rationale: Assessing the client's reasons for refusal identifies barriers (e.g., pain, fear), allowing tailored interventions to encourage compliance with deep-breathing exercises.
The nurse is teaching a group of teenage boys who are on a baseball team about the risks of chewing tobacco. Which of the following should the nurse instruct the teenagers to report to their parents and physicians? Select all that apply.
- A. Dysphagia.
- B. Sessibility in the
- C. Unexplained mouth pain.
- D. Lump in the neck.
- E. Decreased saliva.
- F. White patch on the mucosa.
Correct Answer: C,D,F
Rationale: Chewing tobacco is a known risk factor for oral cancer and other oral health issues. Symptoms such as unexplained mouth pain, a lump in the neck, and white patches on the mucosa are concerning and could indicate serious conditions like oral cancer or precancerous lesions, requiring immediate medical attention. Dysphagia and decreased saliva are less specific and not directly linked to chewing tobacco risks in this context.
A client is receiving streptomycin for the treatment of tuberculosis. The nurse should assess the client for eighth cranial nerve damage by observing the client for:
- A. Vertigo.
- B. Facial paralysis.
- C. Impaired vision.
- D. Difficulty swallowing.
Correct Answer: A
Rationale: Streptomycin can damage the eighth cranial nerve (vestibulocochlear), causing vertigo or hearing loss. Facial paralysis, impaired vision, and difficulty swallowing are associated with other cranial nerves.
Although all of the following measures might be useful in reducing the visual disability of a client with adult macular degeneration (AMD), which measure should the nurse teach the client primarily as a safety precaution?
- A. Wear a patch over one eye.
- B. Place personal items on the sighted side.
- C. Lie in bed with the unaffected side toward the door.
- D. Turn the head from side to side when walking.
Correct Answer: B
Rationale: Placing personal items on the sighted side enhances safety by ensuring the client can see and access items easily, reducing the risk of falls or accidents.
Which teaching point is essential for a client with a seizure disorder?
- A. Avoid all physical activity.
- B. Take medications as prescribed.
- C. Limit sleep to 6 hours nightly.
- D. Restrict fluid intake.
Correct Answer: B
Rationale: Taking medications as prescribed is essential to control seizures and prevent recurrence.