Concepts for Nursing Practice 3rd Edition Test Bank

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The nurse has a 7-year-old client recovering from partial-thickness burns to the arms and hands. This client has shown sensitivity to loud noises and bright lights, and at times if she is overstimulated she won't speak to or look at anyone but her parents until she calms down. The nurse considers the best teaching environment for this client to be the

  • A. client's room.
  • B. pediatric ward waiting area.
  • C. hospital cafeteria.
  • D. pediatric ward play area.
Correct Answer: A

Rationale: For a 7-year-old client recovering from partial-thickness burns with sensitivity to loud noises and bright lights, along with a tendency to become overstimulated, the best teaching environment would be the client's room. This setting provides a familiar and comforting space where the client feels secure and less exposed to external stimuli that may trigger discomfort or anxiety. Being in her own room allows the client to focus better, feel more at ease, and have better communication with the nurse without distractions from bright lights, loud noises, or other people around. This controlled and peaceful environment contributes to a more effective teaching and learning experience for the client, promoting better understanding and retention of information.

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During an assessment, the nurse decides to assess a patient’s calcium level. Which action will the nurse take to identify a low calcium level?

  • A. Palpate turgor of skin
  • B. Observe the color of the skin
  • C. Conduct a Trousseau’s sign test
  • D. Save urine to measure 17-ketosteroids
Correct Answer: C

Rationale: The Trousseau’s sign test is used to identify low calcium levels in a patient. This test involves inflating a blood pressure cuff on the patient's arm above systolic pressure for a few minutes, which can trigger a carpal spasm (wrist and hand flexion) in patients with low calcium levels (hypocalcemia). This is due to increased neuromuscular irritability caused by low calcium levels. Therefore, conducting a Trousseau’s sign test is the appropriate action to identify a low calcium level in a patient. Palpating turgor of skin, observing the color of the skin, and saving urine to measure 17-ketosteroids are not relevant actions for assessing calcium levels.

What is the most accurate tool for assessing and diagnosing venous thrombosis?

  • A. Ascending contrast venography
  • B. Duplex venous ultrasonography
  • C. Magnetic resonance imaging
  • D. Plethysmography
Correct Answer: B

Rationale: Duplex venous ultrasonography is the most accurate tool for assessing and diagnosing venous thrombosis. It is a non-invasive imaging technique that combines Doppler flow studies with conventional ultrasonography. This allows for the visualization of blood flow in the veins and identification of any blood clots or obstructions. Duplex venous ultrasonography is highly sensitive and specific for detecting deep vein thrombosis (DVT) in the lower extremities, making it the preferred imaging modality for diagnosing venous thrombosis. Other imaging modalities like ascending contrast venography, magnetic resonance imaging, and plethysmography are less commonly used due to their disadvantages compared to duplex venous ultrasonography such as invasiveness, cost, and lower accuracy.

A 14-year-old child was recently diagnosed with hypertrophic cardiomyopathy. During a follow-up appointment, the mother asks the nurse, "How will this affect my child's ability to play football in the fall?" How should the nurse respond?

  • A. "This shouldn't affect his ability to play football."
  • B. "Children with cardiomyopathy should not play football."
  • C. "He could participate in flag football but not tackle football."
  • D. "This may actually make him a better, stronger football player."
Correct Answer: B

Rationale: Children diagnosed with hypertrophic cardiomyopathy should not participate in competitive sports such as football due to the potential risk of sudden cardiac events. Physical activity and sports with lower intensity may be allowed, but organized competitive sports with high intensity (such as football) are generally contraindicated. It is important for the health care team to prioritize the child's safety and well-being over sports participation in cases of cardiomyopathy. The nurse should communicate this information to the mother to help her understand the importance of limiting the child's physical activities to reduce the risk of complications related to hypertrophic cardiomyopathy.

A nurse is caring for a client who was involved in a motor vehicle accident and has lost approximately 1,550 mL of blood. The nurse should recognize that the client's shock will be classified as:

  • A. Class I
  • B. Class II
  • C. Class III
  • D. Class IV
Correct Answer: C

Rationale: Class III hemorrhagic shock typically involves the loss of 1,500-2,000 mL of blood, which aligns closely with the approximately 1,550 mL of blood lost by the client in this scenario. Class III shock is considered severe and can lead to significant physiological consequences, including decreased blood pressure, increased heart rate, altered mental status, and potential organ dysfunction. Therefore, based on the amount of blood loss and severity of symptoms, the client's shock would be classified as Class III.

The nurse is providing care to a client who has experienced several episodes of angina. Which agent does the nurse anticipate being ordered to reduce the intensity and frequency of an angina episode?

  • A. The client will experience relief of chest pain with therapeutic lifestyle changes.
  • B. The client will experience relief of chest pain with statin therapy.
  • C. The client will experience relief of chest pain with nitrate therapy.
  • D. The client will experience relief of chest pain with anticoagulant therapy.
Correct Answer: C

Rationale: Nitrates are commonly prescribed for the management of angina. These agents work by dilating blood vessels, which leads to improved blood flow to the heart muscle and decreased workload on the heart. This results in reduced intensity and frequency of angina episodes by increasing oxygen supply to the heart and decreasing its demand. Nitrates can be administered sublingually, orally, or topically to provide prompt relief of chest pain during an angina episode. Thorough patient education should be provided regarding the proper use of nitrates and potential side effects.

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