Nokea
The nurse is caring for a client with a history of polycystic kidney disease.
- A. Which symptom is expected in a client with polycystic kidney disease?
- B. Chest pain and dyspnea.
- C. Flank pain and hematuria.
- D. Weight loss and fever.
- E. Numbness in the extremities.
Correct Answer: B
Rationale: Flank pain and hematuria are common in polycystic kidney disease due to cyst pressure and rupture. Chest pain, weight loss, and numbness are unrelated.
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The nurse is teaching a client with a new diagnosis of rheumatoid arthritis about methotrexate (Rheumatrex). Which of the following instructions should the nurse include?
- A. Take the medication with grapefruit juice.
- B. Avoid folic acid supplements.
- C. Report any fever or sore throat.
- D. Stop the medication if joint pain decreases.
Correct Answer: C
Rationale: Methotrexate can cause bone marrow suppression; fever or sore throat may indicate infection, requiring reporting. Options A, B, and D are incorrect.
When describing the correct way for cleansing a wound site, the nurse understands that the wound should be cleaned:
- A. From the top to the bottom two times, with the swab discarded
- B. From the outermost region to the center
- C. With circular motions from the drainage site to the outermost edges
- D. With normal saline followed by an astringent wash
Correct Answer: C
Rationale: Cleaning from the drainage site outward prevents spreading pathogens. Other methods risk contamination or are inappropriate.
Digoxin has been prescribed for a 70-year-old man who has atrial fibrillation. Which behavior indicates that the client understands the nurse's instructions about taking digoxin?
- A. The client states that he will not spend much time in the sun.
- B. The client says to the nurse, 'Is this the correct way to check my pulse? I want to do it right.'
- C. The client tells the nurse he will be very careful to sit on the edge of the bed for a few moments before standing up.
- D. The client says, 'I will not take Cialis while I am taking this medicine.'
Correct Answer: B
Rationale: Checking pulse before taking digoxin prevents administration if bradycardia is present, indicating understanding of toxicity monitoring.
A baby is delivered following a pregnancy complicated by gestational diabetes. What should the nurse observe the baby for?
- A. Infection
- B. Hyperglycemia
- C. Acidosis
- D. Hypoglycemia
Correct Answer: D
Rationale: Infants of mothers with gestational diabetes are at risk for hypoglycemia due to high fetal insulin levels from maternal hyperglycemia, requiring close monitoring.
A patient with a cuffed tracheostomy tube in place after surgery.
The nurse knows the purpose of the cuff on the tracheostomy tube is to
- A. guarantee secure placement of the tracheostomy tube in the airway.
- B. prevent ischemia of the tracheal wall by distributing the pressure applied to it.
- C. decrease the chance of aspiration into the trachea.
- D. protect the trachea from ischemia and edema.
Correct Answer: C
Rationale: Strategy: Think about each answer choice. (1) inaccurate, not the purpose of the cuff on a tracheostomy tube (2) complication of using a cuffed tracheostomy tube (3) correct-seals trachea, helps to prevent aspiration (4) trauma from overinflated tube may cause edema