Nokea
The nurse has reinforced teaching with a client who has rheumatoid arthritis and is receiving methotrexate. Which of the following statements by the client would require follow-up?
- A. I will avoid drinking alcoholic beverages while taking methotrexate.'
- B. I should take precautions to prevent pregnancy while taking methotrexate.'
- C. I should avoid large crowds and people who are ill while taking methotrexate.'
- D. I will avoid consuming foods high in folic acid that will decrease the effectiveness of methotrexate.'
Correct Answer: D
Rationale: Avoiding alcohol (A), preventing pregnancy (B), and avoiding crowds (C) are correct. Avoiding folic acid (D) is incorrect, as methotrexate often requires folic acid supplementation to reduce side effects.
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A client who is being evaluated for suspected ectopic pregnancy reports sudden-onset, severe, right lower abdominal pain and dizziness. Which of the following additional assessment findings will the nurse anticipate if the client is experiencing a ruptured ectopic pregnancy? Select all that apply.
- A. Blood pressure 82/64 mm Hg
- B. Crackles on auscultation
- C. Distended jugular veins
- D. Pulse 120/min
- E. Shoulder pain
Correct Answer: A, D, E
Rationale: Low blood pressure (A), tachycardia (D), and shoulder pain (E) indicate hemorrhage from a ruptured ectopic pregnancy. Crackles (B) and jugular vein distension (C) are unrelated.
The nurse is assisting with care of a client with blunt head injury admitted for observation, including hourly neurologic checks. At 1:00 AM, the client reports a headache; the neurologic check is normal, and the nurse administers acetaminophen prn. At 2:00 AM, the client appears to be sleeping. What action does the nurse anticipate taking?
- A. Arouse the client and ask what the current month is
- B. Awaken the client and check for paresthesia
- C. Document 'relief apparently obtained' and recheck at 3:00 AM
- D. Let the client sleep but verify respiratory rate
Correct Answer: A
Rationale: Hourly neurologic checks require arousing the client to assess orientation (A). Checking paresthesia (B), assuming relief (C), or only verifying respiratory rate (D) do not meet monitoring requirements.
A client is admitted to the emergency room following an acute asthma attack. Which of the following assessments would be expected by the nurse?
- A. Diffuse expiratory wheezing
- B. Loose, productive cough
- C. No relief from inhalant
- D. Fever and chills
Correct Answer: A
Rationale: In asthma, the airways are narrowed, creating difficulty getting air in. A wheezing sound results.
The client with hyperparathyroidism will exhibit signs of:
- A. Hypokalemia
- B. Hyponatremia
- C. Hypercalcemia
- D. Hyperphosphatemia
Correct Answer: C
Rationale: Hyperparathyroidism increases parathyroid hormone, causing hypercalcemia by mobilizing calcium from bones and increasing absorption. Hypokalemia , hyponatremia , and hyperphosphatemia are not typically associated.
A client continually repeats phrases that others have just said. The nurse recognizes this behavior as
- A. Autistic
- B. Echopraxis
- C. Echolalia
- D. Catatonic
Correct Answer: C
Rationale: Echolalia is repeating words or phrases heard before, often seen in certain psychiatric or developmental conditions.