Nokea
The nurse is assessing a client for tactile fremitus. Which client would most likely exhibit a decrease in tactile fremitus? A client with:
- A. Emphysema
- B. Pneumonia
- C. Tuberculosis
- D. A lung tumor
Correct Answer: A
Rationale: Emphysema causes air trapping and hyperinflation, reducing tactile fremitus due to decreased transmission of vocal vibrations through the lungs.
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A client with obsessive compulsive personality disorder annoys his coworkers with his rigid-perfectionistic attitude and his preoccupation with trivial details. An important nursing intervention for this client would be:
- A. Helping the client develop a plan for changing his behavior
- B. Contracting with him for the time he spends on a task
- C. Avoiding a discussion of his annoying behavior because it will only make him worse
- D. Encouraging him to set a time schedule and deadlines for himself
Correct Answer: D
Rationale: Setting a time schedule helps the client manage perfectionistic tendencies by structuring tasks, reducing preoccupation with trivial details.
The RN is making assignments for the day. Which one of the following duties can be assigned to the unlicensed assistive personnel?
- A. Notifying the physician of an abnormal lab value
- B. Providing routine catheter care with soap and water
- C. Administering two aspirin to a client with a headache
- D. Setting the rate of an infusion of normal saline
Correct Answer: B
Rationale: Unlicensed assistive personnel can perform routine catheter care, a non-invasive task within their scope.
The nurse is caring for a female client following the removal of the parathyroid glands. The client complains of a 'pins and needles' sensation and difficulty swallowing lunch. The nurse would expect which laboratory value to be abnormal?
- A. calcium
- B. potassium
- C. magnesium
- D. blood glucose
Correct Answer: A
Rationale: Parathyroidectomy can cause hypocalcemia, leading to paresthesia ('pins and needles') and dysphagia due to muscle dysfunction.
The nurse is caring for a client diagnosed with glaucoma. The health care provider has ordered timolol maleate. Which finding in the client's history would prompt the nurse to notify the health care provider?
- A. asthma
- B. migraines
- C. atrial fibrillation
- D. urinary tract infection
Correct Answer: A
Rationale: Timolol, a beta-blocker, can exacerbate asthma by causing bronchoconstriction. Other conditions are not contraindications.
A client was to receive 1 g of vancomycin intravenously in 200 mL of iso-osmotic solution over 60 minutes per infusion pump. However, the IV administration was discontinued after 45 minutes because the client developed nausea and chills. How many milligrams of vancomycin did the client receive? Record your answer using a whole number.
Correct Answer: 750
Rationale: 1 g = 1000 mg in 200 mL over 60 min. In 45 min, 45/60 = 0.75 of dose = 0.75 X 1000 = 750 mg.