Nokea
The nurse is teaching a client who has been diagnosed with tuberculosis how to avoid spreading the disease to family members. Which statement(s) by the client indicate(s) that he has understood the nurse's instructions? Select all that apply.
- A. I will need to dispose of my old clothing when I return home.
- B. I should always cover my mouth and nose when sneezing.
- C. I'll be important that I isolate myself from family when possible.
- D. I should use paper tissues to cough in and dispose of them promptly.
- E. I can use regular plates and utensils whenever I eat.
Correct Answer: B,D,E
Rationale: Covering the mouth when sneezing (B), using tissues for coughing and disposing of them (D), and using regular utensils (E) prevent tuberculosis spread. Disposing of clothing is unnecessary. Isolation is only needed until the client is non-infectious (after 2–3 weeks of treatment).
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Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse should teach the client to immediately report which of the following?
- A. Sore throat.
- B. Painful, excessive menstruation.
- C. Constipation.
- D. Increased urine output.
Correct Answer: A
Rationale: Propylthiouracil (PTU) can cause agranulocytosis, a serious condition involving a low white blood cell count, which may present as a sore throat or fever. This requires immediate reporting. The other symptoms are not typically associated with PTU side effects.
The nurse is assigning clients for the evening shift. Which of the following clients are appropriate for the nurse to assign to a licensed practical nurse to provide client care? Select all that apply.
- A. A client with Crohn's disease who is receiving total parenteral nutrition (TPN).
- B. A client who underwent inguinal hernia repair surgery 3 hours ago.
- C. A client with an intestinal obstruction who needs a Cantor tube inserted.
- D. A client with diverticulitis who needs teaching about his take-home medications.
- E. A client who is experiencing an exacerbation of his ulcerative colitis.
Correct Answer: B,D
Rationale: Licensed practical nurses (LPNs) can provide care for stable clients with predictable outcomes, such as a client post-inguinal hernia repair (B) or a client with diverticulitis needing medication teaching (D). Clients requiring TPN monitoring (A), Cantor tube insertion (C), or managing an acute exacerbation of ulcerative colitis (E) require more complex assessments or interventions typically performed by a registered nurse. CN: Management of care; CL: Synthesize
A 34-year-old female is diagnosed with hypothyroidism. The nurse should assess the client for which of the following? Select all that apply.
- A. Rapid pulse.
- B. Decreased energy and fatigue.
- C. Weight gain of 10 lb.
- D. Fine, thin hair with hair loss.
- E. Constipation.
- F. Menorrhagia.
Correct Answer: B,C,D,E,F
Rationale: Hypothyroidism slows metabolism, leading to decreased energy, fatigue, weight gain, hair loss, constipation, and heavy menstrual periods (menorrhagia). Rapid pulse is associated with hyperthyroidism, not hypothyroidism.
A client's husband expresses concern that his dying wife keeps saying, 'I have to go to the store.' Which of the following statements by the nurse will be most effective in assisting the husband to understand the dying process?
- A. Many dying clients are restless and can be treated with sedatives.
- B. The client may be fighting death and you should leave her alone.
- C. Comments related to going somewhere or leaving on a trip are common in dying clients.
- D. Decreased circulation and lack of oxygen to the brain often causes delirium.
Correct Answer: C
Rationale: Statements about leaving or going somewhere are common in dying clients, reflecting their subconscious preparation for death, and this explanation helps the husband understand the behavior.
A client is admitted to the surgical floor after having bowel surgery. The nurse observes that the client's urine output has decreased from 50 to 20 mL/hour. Which of the following is the most likely cause?
- A. Bowel obstruction.
- B. Adverse effect of opioid analgesics.
- C. Hemorrhage.
- D. Hypertension.
Correct Answer: B
Rationale: Opioid analgesics, commonly used post-surgery, can cause urinary retention by relaxing the bladder, reducing urine output. This is the most likely cause in this scenario.