Nokea
The doctor has ordered antithrombolic stockings to be applied to the legs of the client with peripheral vascular disease. The nurse knows antithrombolic stockings should be applied:
- A. Before rising in the morning
- B. With the client in a standing position
- C. After bathing and applying powder
- D. Before retiring in the evening
Correct Answer: A
Rationale: Applying antithrombic stockings before rising prevents venous pooling, maximizing their effectiveness in improving circulation.
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The nurse is reviewing labs on a group of adult clients. Which lab value would prompt the nurse to immediately notify the health care provider?
- A. hemoglobin 4.8 g/dL
- B. troponin T 0.04 ng/mL
- C. phosphorus 3.8 mg/dL
- D. bilirubin (total) 0.7 mg/dL
Correct Answer: A
Rationale: Hemoglobin of 4.8 g/dL is critically low, indicating severe anemia and requiring immediate provider notification. Other values are normal or near-normal.
A client has been diagnosed with renal insufficiency, which has led to pronounced fluid volume excess. The nurse would expect which of the following signs and symptoms? Select all that apply.
- A. decreased urine output
- B. hypotension
- C. jugular vein distention
- D. weak, thready pulse
- E. tachycardia
Correct Answer: A,C,E
Rationale: Renal insufficiency causes fluid retention, leading to decreased urine output, jugular vein distention, and tachycardia (compensatory response). Hypotension and weak pulse are more typical of fluid volume deficit.
A client has experienced 48 hours of severe repeated bouts of vomiting. Which acid-base imbalance is of most concern?
- A. Respiratory acidosis
- B. Respiratory alkalosis
- C. Metabolic acidosis
- D. Metabolic alkalosis
Correct Answer: D
Rationale: Severe vomiting causes loss of gastric acid, leading to metabolic alkalosis (D). Respiratory imbalances (A, B) and metabolic acidosis (C) are less likely.
Following procurement of organs from a standard criteria donor (donor younger than 50 years who suffered brain death), within what time period should the heart and lungs be transplanted?
- A. 4-6 hours
- B. 8-12 hours
- C. 24 hours
- D. 36 hours
Correct Answer: A
Rationale: Heart and lungs have a short ischemic tolerance, requiring transplantation within 4-6 hours (A) to ensure viability. Longer periods (B, C, D) risk organ failure.
A client with preeclampsia has been receiving an infusion containing magnesium sulfate for a blood pressure that is 160/80; deep tendon reflexes are 1 plus, and the urinary output for the past hour is 100 mL. The nurse should:
- A. Continue the infusion of magnesium sulfate while monitoring the client's blood pressure
- B. Stop the infusion of magnesium sulfate and contact the physician
- C. Slow the infusion rate and turn the client on her left side
- D. Administer calcium gluconate IV push and continue to monitor the blood pressure
Correct Answer: A
Rationale: The parameters (BP 160/80, 1+ reflexes, 100 mL urine output) are within acceptable limits, so the infusion should continue.