Nokea
The nurse is reinforcing education to a client with a venous thromboembolism who is prescribed rivaroxaban. Which statement by the client indicates the medication teaching has been effective?
- A. I need to continue to avoid eating spinach and kale.
- B. I probably will have some weakness in my legs when I take this medicine.
- C. I should avoid taking aspirin while receiving this medication.
- D. I will have to get blood drawn routinely to check my clotting levels.
Correct Answer: C
Rationale: Rivaroxaban is a direct oral anticoagulant that does not require routine monitoring of clotting levels, unlike warfarin. It also does not necessitate dietary restrictions like avoiding spinach and kale, which are relevant for warfarin due to vitamin K interactions. Avoiding aspirin is correct because it increases bleeding risk when combined with rivaroxaban. Weakness in legs is not a typical side effect of rivaroxaban.
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Which of the following clients is at highest risk for developing Sarcordosis?
- A. A 40-year-old Caucasian with a history of bronchitis atrial tachycardia
- B. A 30-year-old African-American who is pregnant
- C. A 50-year-old Asian male with emphysema
- D. A 60-year-old Hispanic male with cancer
Correct Answer: B
Rationale: Sarcoidosis is most common in African-Americans, particularly women of childbearing age, making the pregnant 30-year-old African-American the highest risk.
The nurse recognizes that it is acceptable for which pair of clients to be assigned to share a semi-private room?
- A. 35-year-old with blood loss anemia and a 28-year-old diagnosed with severe anorexia nervosa
- B. 50-year-old who had a bowel resection 2 days ago and a 40-year-old diagnosed with pneumonia
- C. 60-year-old who had a total hip arthroplasty yesterday and a 58-year-old with fever of unknown origin
- D. 60-year-old with gastroenteritis and a 70-year-old with diarrhea and vomiting related to chemotherapy
Correct Answer: D
Rationale: Clients with gastroenteritis and chemotherapy-induced diarrhea (D) have similar non-airborne conditions, making them suitable roommates. Pneumonia (B) and fever of unknown origin (C) pose infection risks. Anemia and anorexia (A) are unrelated but not optimal.
The nurse is teaching a client with dysrhythmia about the electrical pathway of an impulse as it travels through the heart. Which of these describes the normal pathway?
- A. AV node, SA node, Bundle of His, Purkinje fibers
- B. Purkinje fibers, SA node, AV node, Bundle of His
- C. Bundle of His, Purkinje fibers, SA node
- D. SA node, AV node, Bundle of His, Purkinje fibers
Correct Answer: D
Rationale: SA node, AV node, Bundle of His, Purkinje fibers. This is the normal pathway of an electrical impulse through the heart.
The nurse in the mental health unit is talking with several clients during group therapy. A client becomes angry and throws a fire extinguisher at another client. Which of the following actions would be a priority for the nurse to take?
- A. Activate the rapid response team.
- B. Approach the client calmly and acknowledge the client's feelings.
- C. Escort other clients away from the area.
- D. Inform the client that the action was dangerous and unacceptable.
Correct Answer: C
Rationale: Ensuring safety by escorting others away (C) is the priority. Rapid response (A) may be premature, approaching the client (B) risks escalation, and informing of consequences (D) is secondary.
The nurse cares for a client diagnosed with Addison disease. Which clinical finding would the nurse anticipate?
- A. Acanthosis nigricans
- B. Hirsutism
- C. Truncal obesity
- D. Weight loss
Correct Answer: D
Rationale: Addison disease causes weight loss (D) due to cortisol deficiency. Acanthosis nigricans (A), hirsutism (B), and truncal obesity (C) are associated with other endocrine disorders.