Nokea
The nurse is reinforcing teaching for the parents of a child newly diagnosed with hemophilia. Which long-term complication is important for the nurse to discuss?
- A. Heart valve injury
- B. Intellectual disability
- C. Joint destruction
- D. Recurrent pneumonia
Correct Answer: C
Rationale: Hemophilia causes recurrent joint bleeds, leading to joint destruction (hemophilic arthropathy), a key long-term complication.
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The nurse is caring for a client with osteoporosis who is being discharged on alendronate (Fosamax). Which statement would indicate effective teaching?
- A. I should take the medication immediately before bedtime.
- B. I should remain in an upright position for 30 minutes after taking the medication.
- C. The medication is more effective if I take it with milk or dairy products.
- D. If I skip a dose, I can take two tablets the next time.
Correct Answer: B
Rationale: This is required to prevent esophageal problems. The medication should be taken in the morning before food or other medications with water, making answers A and C incorrect choices. It should also be taken as ordered, which makes answer D incorrect.
The nurse is reinforcing teaching to a support group for partners of military veterans who have posttraumatic stress disorder (PTSD). The nurse explains that most clients with PTSD experience which symptoms?
- A. Auditory hallucinations and feelings of paranoia
- B. Excessive need for admiration and inflated self-importance
- C. Increased energy levels and euphoric mood
- D. Reliving the event and feeling detached from others
Correct Answer: D
Rationale: PTSD is characterized by reliving traumatic events and detachment (avoidance). Other options describe different disorders.
The oncoming nurse is receiving report on 4 clients. Which should be the priority assessment?
- A. Client who had a carotid endarterectomy that day with a blood pressure of 160/88 mm Hg
- B. Client who is 1 day post bowel resection with absent bowel sounds
- C. Client with a pulse of 109/min who has a history of atrial fibrillation
- D. Client with pancreatitis whose total parenteral nutrition is almost finished
Correct Answer: A
Rationale: Elevated blood pressure (160/88 mm Hg) post-carotid endarterectomy risks hematoma or stroke, making it the priority. Other conditions are less urgent.
The charge nurse on the eating disorder unit instructs a new staff member to weigh each client in his or her hospital gown only. What is the rationale for this nursing intervention?
- A. To reduce the risk of the client feeling cold due to decreased fat and subcutaneous tissue
- B. To cover the bony prominence and areas where there is skin breakdown
- C. The client knows what type of clothing to wear when weighed
- D. To reduce the tendency of the client to hide objects under his or her clothing
Correct Answer: D
Rationale: To reduce the tendency of the client to hide objects under his or her clothing. Clients may conceal weights to falsely indicate weight gain.
A 6 month-old infant who is being treated for developmental dysplasia of the hip has been placed in a hip spica cast. The nurse should teach the parents to
- A. Gently rub the skin with a cotton swab to relieve itching
- B. Place the favorite books and push-pull toys in the crib
- C. Check every few hours for the next day or 2 for swelling in the baby's feet
- D. Turn the baby with the abduction stabilizer bar every 2 hours
Correct Answer: C
Rationale: Check every few hours for the next day or 2 for swelling in the baby's feet. A child in a hip spica cast must be checked for circulatory impairment. The extremities are observed for swelling, discoloration, movement and sensation.