Nokea
The nurse is preparing a client with a deep vein thrombosis (DVT) for a Venous Doppler evaluation. Which of the following would be necessary for preparing the client for this test?
- A. Client should be NPO after midnight
- B. Client should receive a sedative medication prior to the test
- C. Discontinue anti-coagulant therapy prior to the test
- D. No special preparation is necessary
Correct Answer: D
Rationale: This is a non-invasive procedure and does not require preparation other than client education.
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Divalproex sodium (Depakote) is prescribed for a 28-year-old female. Which lab test would the nurse expect prior to administration of the medication?
- A. Urine drug screen
- B. Pregnancy test
- C. CBC with differential
- D. Liver function tests
Correct Answer: B
Rationale: Divalproex is teratogenic; a pregnancy test is critical in females of childbearing age to prevent fetal harm.
An adult is admitted with a pneumothorax following an accident. Immediately after insertion of a chest tube, the client says to the nurse, 'Why do I have a tube in my chest and that thing hanging on the side of the bed? I don't like it.' What should the nurse include when replying to the client?
- A. Tell the client that the chest tube helps the client take bigger breaths
- B. Focus on the client's feelings
- C. Explain that the chest tube will remove air and/or fluid from the pleural cavity and allow the lung to reexpand
- D. Tell the client that the nurse will contact the physician to have it removed
Correct Answer: C
Rationale: The chest tube drains air/fluid from the pleural space, allowing lung re-expansion in pneumothorax, providing an accurate, educational response to the client's question.
A client with diabetes phones the clinic stating, 'I have a terrible cold and I don't know what to do about taking my insulin.' Which of the following should be included in the nurse's teaching regarding the client's insulin needs?
- A. Infections decrease insulin needs, so she should withhold insulin injections until her cold symptoms improve.
- B. Infections cause a drop in blood glucose levels, so she should base her insulin needs on the results of urine glucose tests.
- C. Infections cause alterations and increase insulin needs, so she should check her blood glucose levels and urine ketones at least every 4 hours.
- D. Infections cause no change in insulin requirements, but she should avoid crowds and overfatigue.
Correct Answer: C
Rationale: Infections increase insulin resistance, raising insulin needs. Frequent glucose and ketone monitoring ensures proper management. Withholding insulin or relying on urine tests is dangerous, and infections do alter insulin requirements.
The nurse is observing a staff member caring for a client who had a vaginal birth 30 minutes ago. The client is having difficulty with breastfeeding and is requesting assistance. The nurse should intervene if the staff member is observed
- A. providing supplemental formula feedings until improved breastfeeding occurs
- B. checking the newborn's position and sucking behavior during breastfeeding
- C. demonstrating to the client how to express breastmilk using the hand
- D. providing information on recognizing newborn hunger cues
Correct Answer: A
Rationale: Supplemental formula may undermine breastfeeding efforts early on. Checking position , demonstrating expression , and teaching hunger cues support breastfeeding.
Which statement made by a nurse about the goal of total quality management or continuous quality improvement in a health care setting is correct?
- A. It is to observe reactive service and product problem solving
- B. Improvement of the processes in a proactive, preventive mode is paramount
- C. A chart audits to find to the process in a proactive, preventive mode is paramount
- D. A flow chart to organize daily tasks is critical to the initial stages
Correct Answer: B
Rationale: Improvement of the processes in a proactive, preventive mode is paramount. Total quality management and continuous quality improvement have a major goal of identifying ways to do the right thing at the right time in the right way by proactive problem-solving.