Nokea
The nurse is performing discharge teaching for a client with Addison’s disease.
- A. What is the most important instruction for a client with Addison’s disease?
- B. Signs and symptoms of infection.
- C. Fluid and electrolyte balance.
- D. Seizure precautions.
- E. Steroid replacement.
Correct Answer: D
Rationale: Steroid replacement is critical for Addison’s disease to manage adrenal insufficiency and prevent life-threatening crises. Infection, fluid balance, and seizures are secondary concerns compared to ensuring steroid therapy adherence.
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The nurse is caring for a client with a history of anxiety disorder.
- A. Which intervention is most effective for managing acute anxiety in a client?
- B. Administer a benzodiazepine as ordered.
- C. Encourage deep breathing exercises.
- D. Restrict the client to their room.
- E. Provide a high-stimulus environment.
Correct Answer: B
Rationale: Deep breathing exercises calm the autonomic nervous system, reducing acute anxiety effectively and non-invasively. Benzodiazepines are used cautiously, isolation increases anxiety, and high-stimulus environments worsen it.
The nurse is caring for a client who is postoperative day 1 after a thyroidectomy. Which of the following findings should the nurse report immediately?
- A. Mild pain at the incision site.
- B. Temperature of 100.8°F (38.2°C).
- C. Heart rate of 80 bpm.
- D. Calcium level of 9.0 mg/dL.
Correct Answer: B
Rationale: A temperature of 100.8°F suggests infection, a serious post-thyroidectomy complication. Options A, C, and D are normal or expected.
The nurse is teaching a client with a new diagnosis of atrial fibrillation about diltiazem (Cardizem). Which of the following statements by the client indicates a need for further teaching?
- A. I should check my pulse before taking this medication.
- B. I should report swelling in my legs to my doctor.
- C. I should take this medication with grapefruit juice.
- D. I should avoid driving if I feel dizzy.
Correct Answer: C
Rationale: Taking diltiazem with grapefruit juice is incorrect, as it increases drug levels, risking toxicity. Options A, B, and D are correct: pulse monitoring detects bradycardia, leg swelling may indicate heart failure, and avoiding driving with dizziness prevents accidents.
A nursing assistant states that her five-year-old child has developed chickenpox.
It would be MOST important for the nurse to ask which of the following questions?
- A. Have your other children had chickenpox?'
- B. Does your child have a temperature?'
- C. Have you had the chickenpox?'
- D. Do you have someone to watch your child?'
Correct Answer: C
Rationale: Strategy: 'MOST important' indicates there may be more than one answer that you would like to select. Remember, you can only ask one question. (1) chickenpox spread by direct contact, airborne route; not the most important question (2) fever, malaise, and anorexia occur during first 24 hours; treat with Tylenol (3) correct-need to ascertain if staff has had the disease; if not, VZIG can be given; exclude from patient care from the 10th day after first exposure through the 21st day (28th day if VZIG given) after last exposure (4) important information, but assessing staff is most important
The client asks the nurse how the health care provider could tell she was pregnant 'just by looking inside.' What is the best explanation by the nurse?
- A. Bluish coloration of the cervix and vaginal walls
- B. Pronounced softening of the cervix
- C. Clot of very thick mucous that obstructs the cervical canal
- D. Slight rotation of the uterus to the right
Correct Answer: A
Rationale: Chadwick's sign is a bluish-purple coloration of the cervix and vaginal walls, occurring at 4 weeks of pregnancy, that is caused by vasocongestion.