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The nurse is preparing to give a heparin injection to a client who is severely malnourished and has minimal adipose tissue. Which method of injection would be appropriate for this client?
- A. EX12_Q49_1.PNG
- B. EX12_Q49_2.PNG
- C. EX12_Q49_3.PNG
- D. EX12_Q49_4.PNG
Correct Answer: C
Rationale: For a malnourished client with minimal adipose tissue, heparin should be injected at a 90-degree angle using a 25-gauge needle to ensure subcutaneous delivery without hitting muscle.
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The nurse is caring for a client with mild Alzheimer disease who is agitated after eating breakfast. The client states, 'I am hungry. You did not feed me.' Which of the following actions should the nurse take?
- A. Offer the client finger foods to eat.
- B. Provide the client with additional food at mealtimes.
- C. Tell the client that the client may have a snack before lunch.
- D. Ask the dietician to evaluate the client's daily calorie requirements
Correct Answer: C
Rationale: For an Alzheimer client with agitation and false hunger claims, offering a snack before lunch calms the client without overfeeding. Finger foods or extra meals may not address agitation, and a dietician evaluation is less immediate.
The nurse is caring for a client with a venous stasis ulcer. Which nursing intervention would be most effective in promoting healing?
- A. Apply dressing using sterile technique
- B. Improve the client's nutrition status
- C. Initiate limb elevation and compression
- D. Begin proteolytic debridement
Correct Answer: B
Rationale: The goal of clinical management in a client with venous stasis ulcers is to promote healing. This only can be accomplished with proper nutrition. The other interventions are appropriate, but without proper nutrition, they would be of little help.
The nurse is assessing a 1-month-old infant with atrial septal defect. Which of the following findings would be consistent with the condition?
- A. cyanosis
- B. muffled heart tones
- C. murmur
- D. weak femoral pulses
Correct Answer: C
Rationale: An atrial septal defect often presents with a heart murmur due to abnormal blood flow. Cyanosis is rare unless severe, muffled tones are not typical, and weak femoral pulses suggest coarctation of the aorta.
The charge nurse on a cardiac unit tells you a patient is exhibiting signs of right-sided heart failure. Which of the following would not indicate right-sided heart failure?
- A. Nausea
- B. Anorexia
- C. Rapid weight gain
- D. SOB (shortness of breath)
Correct Answer: D
Rationale: Left sided heart failure exhibits signs of pulmonary compromise (SOB).
A client comes to the emergency department for the second time with shortness of breath and substernal pressure that radiates to the jaw. The nurse understands that angina pectoris may be precipitated by which of these factors? Select all that apply.
- A. Amphetamine use
- B. Cigarette smoking
- C. Cold exposure
- D. Deep sleep
- E. Sexual intercourse
Correct Answer: A,B,C,E
Rationale: Angina can be triggered by amphetamines increasing cardiac demand, smoking causing vasoconstriction, cold exposure inducing vasospasm, and sexual intercourse raising heart rate. Deep sleep typically reduces demand.