Nokea
The nurse is caring for a client with peripheral vascular disease. To correctly assess the oxygen saturation level, the monitor may be placed on the:
- A. Hip
- B. Ankle
- C. Earlobe
- D. Chin
Correct Answer: C
Rationale: The earlobe is a suitable site for pulse oximetry in peripheral vascular disease, as it is less affected by impaired peripheral circulation.
You may also like to solve these questions
The nurse is preparing to administer streptomycin 0.25 g. The directions say to reconstitute with 9 mL of sterile water for a concentration of 400 mg/2 mL. How many mLs will the nurse give? Fill in the blank.
Correct Answer: 1.25 mL
Rationale: Dose: 0.25 g = 250 mg. Concentration: 400 mg/2 mL = 200 mg/mL. Volume = 250 mg ÷ 200 mg/mL = 1.25 mL.
A 4-year-old male is admitted to the unit with nephrotic syndrome. He is extremely edematous. To decrease the discomfort associated with scrotal edema, the nurse should:
- A. Apply ice to the scrotum
- B. Elevate the scrotum on a small pillow
- C. Apply heat to the abdominal area
- D. Administer an analgesic
Correct Answer: B
Rationale: Elevating the scrotum reduces edema by promoting fluid drainage, decreasing discomfort.
The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?
- A. The client with methcillin resistant-staphylococcus aureas (MRSA)
- B. The client with diabetes
- C. The client with pancreatitis
- D. The client with Addison's disease
Correct Answer: A
Rationale: Clients with MRSA require contact precautions due to the highly contagious nature of the infection, necessitating a private room to prevent transmission to others.
The nurse is caring for a client hospitalized with nephotic syndrome. Based on the client's treatment, the nurse should:
- A. Limit the number of visitors
- B. Provide a low-protein diet
- C. Discuss the possibility of dialysis
- D. Offer the client additional fluids
Correct Answer: D
Rationale: Nephrotic syndrome causes fluid retention, but adequate hydration is needed to maintain renal perfusion, so offering additional fluids is appropriate.
Which clinical manifestation during the actual bone marrow transplantation alerts you to the possibility of an adverse reaction?
- A. Fever
- B. Red urine
- C. Hypertension
- D. Shortness of breath
Correct Answer: D
Rationale: Shortness of breath during bone marrow transplantation may indicate an anaphylactic or transfusion reaction, requiring immediate intervention.