Nokea
The nurse assesses a wound with exudate. What should not be included when
documenting the exudate?
- A. Amount
- B. Consistency
- C. Heat
- D. Odor
Correct Answer: C
Rationale:
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A client states that he has been experiencing oozing from his wounds. What is
the nurse's priority action?
- A. Insert the wound and assess the drainage
- B. Apply topical ointment to the wound
- C. Call the provider to initiate antibiotics
- D. Culture the wound
Correct Answer: D
Rationale:
The nurse is most concerned about which of these findings in a client with
systemic lupus erythematous?
- A. The client reports chronic fatigue
- B. The client has a butterfly rash
- C. Blood pressure of 126/85 mm Hg
- D. Urine output of 20 mL/hour
Correct Answer: D
Rationale:
A client has a new diagnosis of human immunodeficiency virus HIV. The client
is distraught and does not know what to do. What intervention by the nurse is
the best?
- A. Offer to tell the family for the client
- B. Call the hospital clergy to speak with the client
- C. Assess the client's support system
- D. Explain the legal requirements to tell sex partners
Correct Answer: C
Rationale:
What is an example of a client's primary defense to infection?
- A. Intact skin
- B. Inflammation
- C. Phagocytosis
- D. Fever
Correct Answer: A
Rationale:
Which of the following clients should be placed in isolation for airborne
precautions?
- A. A high school wrestling championship with a rash
- B. A client that recently travelled and developed a fever with cough
- C. A client with an unknown skin infection
- D. A client with heart palpitations
Correct Answer: B
Rationale: