Nokea
The nurse caring for a 14 year-old boy with severe Hemophilia A, who was admitted after a fall while playing basketball. In understanding his behavior and in planning care for this client, the nurse should understand that adolescents with hemophilia
- A. Must have structured activities
- B. Often take part in active sports
- C. Explain limitations to peers
- D. Avoid risks after bleeding episodes
Correct Answer: B
Rationale: Often take part in active sports. Adolescents with hemophilia may engage in sports, requiring careful monitoring to prevent bleeding.
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An adult has experienced significant vomiting and diarrhea for the past 24 hours. Her chloride level is 90 mEq/L. What would the nurse expect to find when interpreting her sodium level?
- A. It would be high.
- B. It is impossible to predict the sodium level with this information.
- C. It would be low.
- D. It would be normal.
Correct Answer: C
Rationale: Vomiting and diarrhea cause sodium loss, likely resulting in a low sodium level, consistent with a low chloride level.
An adult is admitted with pernicious anemia. Which factor in the client's history is most likely related to the development of pernicious anemia?
- A. The client had an upper gastrointestinal (GI) bleed a year ago.
- B. The client had chemotherapy three months ago.
- C. The client had a gastrectomy six months ago.
- D. The client's mother had iron deficiency anemia
Correct Answer: C
Rationale: Gastrectomy removes the stomach's intrinsic factor-producing cells, leading to vitamin B12 malabsorption, a primary cause of pernicious anemia.
A 68-year-old man is diagnosed with myasthenia gravis. The nurse instructs the client about his disease. Which of the following statements, if made by the client to the nurse, indicates the need for further teaching?
- A. I should not drink alcoholic beverages.
- B. I should not go places that are crowded.
- C. I should try to stay calm.
- D. I should use my hot tub daily.
Correct Answer: D
Rationale: Hot tubs cause heat exposure, which can exacerbate myasthenia gravis symptoms, indicating a need for further teaching. Options A, B, and C are correct: alcohol worsens symptoms, crowds increase infection risk, and stress can trigger exacerbations.
While monitoring the urine specific gravity of a client with a head injury, the nurse notes that the client's specific gravity is 1.004 . The most likely explanation for this finding is:
- A. The client is adequately hydrated.
- B. The client is experiencing renal failure.
- C. The client has adequate ADH secretion.
- D. The client is experiencing diabetes insipidus.
Correct Answer: D
Rationale: A low specific gravity (1.004) suggests dilute urine, common in diabetes insipidus due to impaired ADH secretion, often seen in head injuries.
The nurse is caring for a client with a pressure ulcer.
- A. Which intervention is most effective for promoting healing of a stage III pressure ulcer?
- B. Apply a hydrocolloid dressing.
- C. Cleanse the wound with hydrogen peroxide.
- D. Reposition the client every 4 hours.
- E. Administer oral antibiotics.
Correct Answer: A
Rationale: A hydrocolloid dressing maintains a moist environment, promoting healing in a stage III pressure ulcer. Hydrogen peroxide is cytotoxic, repositioning every 2 hours is standard, and antibiotics are only used for infection.