Nokea
The nurse is performing discharge teaching on a client with polycythemia vera. Which would be included in the teaching plan?
- A. Avoid large crowds
- B. Keep the head of the bed elevated at night
- C. Wear socks and gloves when going outside
- D. Recognize clinical manifestations of thrombosis
Correct Answer: D
Rationale: Polycythemia vera increases blood viscosity, raising thrombosis risk. Teaching clients to recognize thrombosis symptoms (e.g., swelling, pain) is critical for early intervention.
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A client with sickle cell anemia is admitted to the labor and delivery unit during the first phase of labor. The nurse should anticipate the client's need for:
- A. Supplemental oxygen
- B. Fluid restriction
- C. Blood transfusion
- D. Delivery by Caesarean section
Correct Answer: A
Rationale: Sickle cell anemia increases oxygen demand during labor, often requiring supplemental oxygen.
The home health care nurse is caring for a 30-year-old woman with type I diabetes mellitus. The client has been maintained on a regimen of NPH and regular insulin and a 1,800-calorie diabetic diet with normal blood sugar levels. Morning self-monitoring blood sugar (SMBG) readings the past two days were 205 mg/dL and 233 mg/dL. The nurse expects the physician to
- A. reduce the client’s diet to 1,500 calorie ADA.
- B. order 3 additional units of NPH insulin at 10 PM.
- C. order an additional 10 units of regular insulin at 8 PM.
- D. eliminate the client’s bedtime snack.
Correct Answer: B
Rationale: dawn phenomena, treatment is to adjust evening diet, bedtime snack, insulin dose, and exercise to prevent early morning hyperglycemia
A client in the ICU is given procainamide HCl (Pronestyl) slowly IV push. The nurse should withhold the next dose of this medication and notify the physician if which of the following is observed on the cardiac monitor?
- A. One premature ventricular contraction (PVC).
- B. Sinus rhythm with occasional bigeminy.
- C. Persistent tachycardia of 112 beats per minute.
- D. Prolongation of the QT interval.
Correct Answer: D
Rationale: prolongation of the QT interval is a side effect that can lead to torsades de pointes, a life-threatening arrhythmia
One week after discharge of a postpartum client, the client's husband calls the postpartum unit and asks the nurse, 'Is it normal for my wife to cry at the drop of a hat? I'm worried I've done something to upset her.' The nurse's best initial response would be:
- A. Have you noticed any pattern to her periods of crying?
- B. Try not to worry about it. I'm sure it's just the postpartum blues.
- C. Can you think of something you might have done to upset her?
- D. Let's consider some of the ways you can decrease her depression.
Correct Answer: B
Rationale: Postpartum blues are common within the first two weeks, characterized by emotional lability. Reassuring the husband while acknowledging the normalcy of this condition is appropriate.
A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of Sydenham's chorea?
- A. Irregular movements of the extremities and facial grimacing
- B. Painless swellings over the extensor surfaces of the joints
- C. Faint areas of red demarcation over the back and abdomen
- D. Swelling, inflammation, and effusion of the joints
Correct Answer: A
Rationale: Sydenham's chorea, a manifestation of rheumatic fever, is characterized by irregular, involuntary movements and facial grimacing.