Nokea
The female client is diagnosed with rheumatic fever and prescribed penicillin, an antibiotic. Which statement indicates the client needs more teaching concerning the discharge teaching?
- A. I must take all the prescribed antibiotics.'
- B. I may get a vaginal yeast infection with penicillin.'
- C. I will have no problems as long as I take my medication.'
- D. My throat culture was positive for a streptococcal infection.'
Correct Answer: C
Rationale: Assuming no problems with medication (C) ignores potential complications like recurrence, indicating a need for teaching. Completing antibiotics (A), yeast infection (B), and strep culture (D) are correct.
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A client is being seen in the clinic to rule out (R/O) mitral valve stenosis. Which assessment data would be most significant?
- A. The client complains of shortness of breath when walking.
- B. The client has jugular vein distention and 3+ pedal edema.
- C. The client complains of chest pain after eating a large meal.
- D. The client's liver is enlarged and the abdomen is edematous.
Correct Answer: A
Rationale: Shortness of breath on exertion (A) is a hallmark of mitral valve stenosis due to impaired left atrial emptying. JVD/edema (B), postprandial pain (C), and liver/abdominal edema (D) suggest right-sided failure or other causes.
Using the following cardiac structures, trace the normal stress in which blood circulates on the left side of the heart. Use all the options.
- A. Aorta
- B. Left ventricle
- C. Pulmonary veins
- D. Left atrium
- E. Mitral valve (correct sequence: 3, 4, 5, 2, 1)
Correct Answer: D
Rationale: Blood flows: pulmonary veins → left atrium → mitral valve → left ventricle → aorta.
Which nursing response is most appropriate at this time?
- A. Cleaning up the floor and saying nothing
- B. Finding out what food would be preferred
- C. Allowing the client to vent his or her feelings
- D. Leaving the client alone until feeling better
Correct Answer: C
Rationale: Allowing the client to vent feelings addresses emotional distress and supports coping.
The telemetry nurse is unable to read the telemetry monitor at the nurse’s station. Which intervention should the telemetry nurse implement first?
- A. Go to the client's room to check the client.
- B. Instruct the primary nurse to assess the client.
- C. Contact the client on the client call system.
- D. Request the nursing assistant to take the crash cart to the client's room.
Correct Answer: A
Rationale: An unreadable monitor (A) requires direct client assessment to ensure safety. Instructing another nurse (B), calling (C), or crash cart (D) are premature without assessment.
The nurse enters the room of the client diagnosed with congestive heart failure. The client is lying in bed gasping for breath, is cool and clammy, and has buccal cyanosis. Which intervention would the nurse implement first?
- A. Sponge the client's forehead.
- B. Obtain a pulse oximetry reading.
- C. Take the client's vital signs.
- D. Assist the client to a sitting position.
Correct Answer: D
Rationale: Gasping, clamminess, and cyanosis indicate acute pulmonary edema. Sitting upright (D) improves breathing by reducing preload. Sponging (A), pulse oximetry (B), and vital signs (C) are secondary to positioning.