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The nurse is caring for a client with a history of chronic lymphocytic leukemia.
- A. Which symptom should the nurse report immediately for a client with chronic lymphocytic leukemia?
- B. Fatigue and weakness.
- C. Enlarged, painless lymph nodes.
- D. Fever and night sweats.
- E. A hemoglobin of 9.0 g/dL.
Correct Answer: C
Rationale: Fever and night sweats may indicate infection or disease progression in chronic lymphocytic leukemia, requiring immediate evaluation. Fatigue, lymph node enlargement, and low hemoglobin are expected.
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A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to:
- A. Take his insulin each day at 1400 hours
- B. Engage in physical activity daily
- C. Increase the amount of regular insulin
- D. Eat a protein and carbohydrate snack at bedtime
Correct Answer: D
Rationale: Somogyi's effect involves rebound hyperglycemia due to nighttime hypoglycemia. A bedtime snack with protein and carbohydrates prevents hypoglycemia. Options A, B, and C do not directly address this issue.
A client is seen in the clinic for complaints of back pain.
Which of the following actions, if performed by the client, would indicate that teaching has been effective?
- A. The client bends over to put on and tie her tennis shoes.
- B. The client stands on her toes to place a box on the top shelf of a closet.
- C. The client sits in a recliner with her feet elevated to watch TV.
- D. The client stands with her feet close together and shifts her weight between her feet.
Correct Answer: C
Rationale: Strategy: 'Teaching has been effective' indicates a true statement. (1) causes stress on lumbar region of back (2) causes stress on lower spine (3) correct-provides lumbar flexion, decreasing pressure on lower spine (4) should have feet apart for wide base of support
A 10-year-old child is admitted to the hospital with injuries. Which finding most suggests that additional assessment for child abuse is indicated?
- A. The child asks to have friends visit.
- B. The child asks to have a teacher bring in homework.
- C. The child's parents state that they need to spend some time with the child's siblings.
- D. The child's parents will not leave the child alone while in the hospital.
Correct Answer: D
Rationale: Constant parental presence may indicate control or fear of the child disclosing abuse, warranting further abuse assessment.
A mother calls the clinic, concerned that her 5 week-old infant is 'sleeping more than her brother did.' What is the best initial response?
- A. Do you remember his sleep patterns?'
- B. How old is your other child?'
- C. Why do you think this a concern?'
- D. Does the baby sleep after feeding?'
Correct Answer: C
Rationale: Open ended questions encourage further discussion and conversation, thereby eliciting further information.
Which of the following statements describes Piaget's stage of concrete operations?
- A. Reflex activity proceeds to imitative behavior.
- B. There is an increased ability to see another's point of view.
- C. Thought processes become more logical and coherent.
- D. The ability to think abstractly leads to logical conclusions.
Correct Answer: C
Rationale: Concrete operations (ages 7-11) involve logical, coherent thought about concrete events. Perspective-taking develops but is not primary, and abstract thinking is characteristic of later stages.