Nokea
The nurse is caring for a client who has psoriasis. Which observation by the nurse is most consistent with the diagnosis?
- A. The client has thick, yellow toenails.
- B. The client has open, weeping lesions.
- C. The skin lesions are multicolored.
- D. The pain follows a nerve root.
Correct Answer: B
Rationale: Psoriasis typically presents with dry, scaly plaques that may crack and weep, consistent with open lesions. Yellow nails, multicolored lesions, or nerve pain are unrelated.
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A client with pernicious anemia is admitted. What would the nurse expect the admitting assessment to reveal?
- A. Ecchymoses on the trunk
- B. Bilateral neuropathy of the legs
- C. Decreased platelet count
- D. Decreased appetite
Correct Answer: B
Rationale: Pernicious anemia, a vitamin B12 deficiency, often causes neurological symptoms like bilateral leg neuropathy due to nerve demyelination.
The nurse is caring for a client with a complete heart block. The nurse should question which of the following orders?
- A. Administer lidocaine (Xylocaine) 50 mg IV push for PVCs in excess of six per minute.
- B. Administer atropine sulfate (Atropine) 0.05 mg IV for symptomatic bradycardia.
- C. Anticipate scheduling the client for a temporary pacemaker if the pulse continues to decrease.
- D. Mix 10 cc of 1:5,000 solution of isoproterenol (Isuprel) in 500 cc D5W for sustained bradycardia below 30.
Correct Answer: A
Rationale: Lidocaine suppresses ventricular activity, which could worsen complete heart block by reducing the ventricular escape rhythm. Options B, C, and D are appropriate: atropine increases heart rate, pacemakers treat persistent bradycardia, and isoproterenol supports severe bradycardia.
An elderly client is admitted to the unit with a temperature of $100.2^{\circ}$, urinary specific gravity of 1.032, and a dry tongue. The nurse should anticipate an order for:
- A. An antibiotic
- B. An analgesic
- C. A diuretic
- D. An IV of normal saline
Correct Answer: D
Rationale: The symptoms (fever, high urinary specific gravity, dry tongue) indicate dehydration. IV normal saline is the priority to rehydrate. Antibiotics require infection confirmation, analgesics address pain, and diuretics worsen dehydration.
Which client should receive a private room?
- A. A client with diabetes
- B. A client with Cushing's disease
- C. A client with Graves' disease
- D. A client with gastric ulcers
Correct Answer: D
Rationale: A client with gastric ulcers may have Helicobacter pylori infection, which can be contagious and requires isolation precautions. Clients with diabetes, Cushing's disease, or Graves' disease do not typically require private rooms unless they have a contagious condition.
The nurse is caring for an adult who has had nausea and vomiting for several days and is being admitted to the nursing care unit. The client can follow directions. IV fluids were started in the emergency department. Which action is the highest priority for the nurse at this time?
- A. Offer oral fluids every hour.
- B. Turn every two hours.
- C. Monitor urine output.
- D. Put client in a supine position.
Correct Answer: C
Rationale: Monitoring urine output is critical to assess hydration status and kidney function in a client with prolonged nausea and vomiting, as dehydration is a major risk. IV fluids address dehydration, making oral fluids less urgent, and turning or positioning are secondary.