Nokea
The nurse is caring for a client with B-thalassemia major. Which therapy is used to treat B-thalassemia major?
- A. IV fluids
- B. Frequent blood transfusions
- C. Oxygen therapy
- D. Iron therapy
Correct Answer: B
Rationale: B-thalassemia major causes severe anemia due to defective hemoglobin synthesis, requiring frequent blood transfusions to maintain hemoglobin levels. IV fluids, oxygen, and iron therapy (which can cause overload) are not primary treatments.
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Which actions should be utilized prior to performing a tub bath on the 80 year-old client?
- A. Fill the tub one-half full of water at should be 46°C.
- B. Put a rubber mat on the bottom of the tub.
- C. Maintain water flow pressure during the bath.
- D. Check water temperature using a bath thermometer.
- E. Wash and dry the client's back moving from shoulders to buttocks.
- F. Perform back massage upon completion of the bath.
Correct Answer: B, D
Rationale: For an 80-year-old client, safety and comfort are priorities during a tub bath. A rubber mat (B) prevents slipping, crucial for elderly clients with reduced mobility. Checking water temperature with a bath thermometer (D) ensures the water is safe (typically 38-40°C, as 46°C is too hot). Filling the tub half full at 46°C (A) risks burns, and maintaining water flow pressure (C) is unnecessary and unsafe. Washing the back (E) and performing a massage (F) occur during or after the bath, not prior.
The client is admitted with a diagnosis of molar pregnancy. Which symptom is most likely to be present?
- A. Severe nausea and vomiting
- B. Uterine size smaller than expected
- C. Fetal heart tones at 12 weeks
- D. All of the above
Correct Answer: A
Rationale: Molar pregnancy (hydatidiform mole) often causes severe nausea and vomiting due to high levels of human chorionic gonadotropin (hCG). The uterus is typically larger than expected and fetal heart tones are absent as there is no viable fetus.
The nurse in the emergency room is caring for a client with multiple rib fractures and a pulmonary contusion. Assessment reveals a respiratory rate of 38, a heart rate of 136, and restlessness. Which associated assessment finding would require immediate intervention?
- A. Occasional small amounts of hemoptysis
- B. Midline trachea with wheezing on auscultation
- C. Subcutaneous air and absent breath sounds
- D. Pain when breathing deeply, with rales in the upper lobes
Correct Answer: C
Rationale: Subcutaneous air and absent breath sounds suggest pneumothorax, requiring immediate intervention (e.g., chest tube). Hemoptysis (A), wheezing (B), and pain/rales (D) are concerning but less urgent.
The nurse is developing a plan of care for a client with a newly created ileostomy. The priority nursing diagnosis for this client is:
- A. Risk for deficient fluid volume related to excessive fluid loss from ostomy
- B. Disturbed body image related to presence of ostomy
- C. Risk for impaired skin integrity related to irritation from ostomy appliance
- D. Deficient knowledge of ostomy care related to unfamiliarity with information resources
Correct Answer: A
Rationale: Excessive fluid loss from a new ileostomy can lead to dehydration, making risk for deficient fluid volume the priority nursing diagnosis to ensure physiological stability.
The client with a history of diabetes insipidus is admitted with polyuria,polydipsia,and mental confusion. The priority intervention for this client is:
- A. Measuring the urinary output
- B. Checking the vital signs
- C. Encouraging increased fluid intake
- D. Weighing the client
Correct Answer: B
Rationale: Mental confusion in diabetes insipidus may indicate severe dehydration or electrolyte imbalances. Checking vital signs is the priority to assess for instability (e.g. hypotension tachycardia) and guide immediate treatment. The other interventions are secondary.