Nokea
The nurse is caring for a client with a history of hemophilia.
- A. Which intervention is most important for a client with hemophilia experiencing joint pain?
- B. Administer factor replacement therapy.
- C. Apply warm compresses to the joint.
- D. Encourage active range-of-motion exercises.
- E. Administer oral analgesics.
Correct Answer: A
Rationale: Factor replacement therapy stops bleeding in hemophilia, relieving joint pain from hemarthrosis. Cold compresses are used, exercise worsens bleeding, and analgesics are supportive.
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The nurse is making assignments for the day. The staff consists of an RN, an LPN, and a nursing assistant. Which client should be assigned to the nursing assistant?
- A. A client with laparoscopic cholecystectomy
- B. A client with viral pneumonia
- C. A client with suspected ectopic pregnancy
- D. A client with intermittent chest pain
Correct Answer: B
Rationale: A nursing assistant can provide basic care such as hygiene and vital signs for stable clients. A client with viral pneumonia, if stable, requires less complex care compared to post-surgical , potential emergency , or cardiac clients, which require licensed staff.
A client who has a panic disorder is receiving paroxetine HCl (Paxil). The client has been taking the drug for one week and is still having severe panic attacks. The client tells the nurse that she thinks the drug is not working. What is the best response for the nurse to make?
- A. You should ask your physician for a different drug.
- B. The physician will probably add another drug to your regimen.
- C. You should stop taking the medication if it is not effective.
- D. It takes two to four weeks for Paxil to be effective.
Correct Answer: D
Rationale: Paroxetine, an SSRI, requires 2-4 weeks to reach therapeutic effect for panic disorder, explaining the continued symptoms.
The nurse recognizes which of these symptoms as characteristic of a panic attack?
- A. Palpitations, decreased perceptual field, diaphoresis, fear of going crazy.
- B. Decreased blood pressure, chest pain, choking feeling.
- C. Increased blood pressure, bradycardia, shortness of breath.
- D. Increased respiratory rate, increased perceptual field, increased concentration ability.
Correct Answer: A
Rationale: panic disorders are characterized by recurrent, unpredictable attacks of intense apprehension or terror that can render a client unable to control a situation or to perform simple tasks; client can experience palpitations, chest pain, shortness of breath, a decrease in perceptual field, and a fear of 'losing it' or going crazy
A client with tuberculosis is started on Rifampin. Which one of the following statements by the nurse would be appropriate to include in teaching? 'You may notice:
- A. an orange-red color to your urine.'
- B. your appetite may increase for the first week.'
- C. it is common to experience occasional sleep disturbances.'
- D. if you take the medication with food, you may have nausea.'
Correct Answer: A
Rationale: Discoloration of the urine and other body fluids may occur. It is a harmless response to the drug, but the patient needs to be aware it may happen.
The nurse is doing a pain assessment on the client who has chronic back pain. Which assessment is of greatest value?
- A. Observe the client for grimaces, flinching, and other signs of pain.
- B. Monitor the client's blood pressure.
- C. Ask the client to rate his pain on a scale of 1 to 10.
- D. Monitor the client's pulse and respirations.
Correct Answer: C
Rationale: Self-reported pain rating (1-10 scale) is the most reliable indicator of pain intensity, guiding treatment effectively.