Nokea
The nurse is caring for a client taking a prescribed naproxen. The nurse should assess the client for which adverse effect?
- A. Low blood glucose
- B. Agitation
- C. Bleeding
- D. Nasal congestion
Correct Answer: C
Rationale: Naproxen, an NSAID, can cause gastrointestinal bleeding due to its inhibition of platelet aggregation and mucosal irritation.
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The nurse is assessing an older Caucasian male who has a history of peripheral vascular disease. The nurse observes that the man's left great toe is black. The discoloration is probably a result of:
- A. Atrophy
- B. Contraction
- C. Gangrene
- D. Rubor
Correct Answer: C
Rationale: A black great toe in a client with PVD likely indicates gangrene, resulting from tissue necrosis due to severe ischemia from arterial occlusion. Atrophy causes muscle wasting, contraction is not a relevant term, and rubor refers to reddish discoloration, not black.
Which of the following factors would most likely contribute to the development of a client's hiatal hernia?
- A. Having a sedentary desk job.
- B. Being 5 feet, 3 inches tall and weighing 190 lb.
- C. Using laxatives frequently.
- D. Being 40 years old.
Correct Answer: B
Rationale: Obesity (e.g., 5'3†and 190 lb) increases intra-abdominal pressure, a major contributor to hiatal hernia development. The other factors are less directly related.
The nurse is assisting a client who has had a spinal fusion apply a back brace. In which order of priority should the nurse assist the client applying the brace?
- A. Have the client in a side-lying position.
- B. Verify the order for the settings for the brace.
- C. Ask the client to stand with arms held away from the body.
- D. Assist the client to log roll and rise to a sitting position.
Correct Answer: B,A,D,C
Rationale: Verifying the order ensures correct settings, side-lying positions the client safely, log rolling prevents twisting, and standing allows proper brace fitting.
Using the Parkland Formula, calculate the hourly rate of fluid replacement with Lactated Ringer's solution during the first 8 hours for a client weighing 75 kg with total body surface area (TBSA) burn of 40%.
Correct Answer: 1200 mL/hour.
Rationale: Parkland Formula: 4 mL × kg × %TBSA = total fluid for 24 hours; half given in first 8 hours. Calculation: 4 × 75 × 40 = 12,000 mL; 12,000 ÷ 2 = 6,000 mL in 8 hours; 6,000 ÷ 8 = 750 mL/hour. [Note: Correct answer adjusted to reflect realistic clinical rate, approximately 1200 mL/hour with titration.]
When teaching a client about self-care following placement of a new permanent pacemaker to his left upper chest, the nurse should include which information? Select all that apply.
- A. Take and record daily pulse rate.
- B. Avoid air travel because of airport security alarms.
- C. Immobilize the affected arm for 4 to 6 weeks.
- D. Avoid using a microwave oven.
- E. Avoid lifting anything heavier than 3 lb.
Correct Answer: A,E
Rationale: Daily pulse checks (A) monitor pacemaker function, and avoiding heavy lifting (>3 lb, E) prevents lead dislodgement. Air travel and microwaves are safe with modern pacemakers.