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The nurse is teaching a client with a new diagnosis of atrial fibrillation about dabigatran (Pradaxa). Which of the following instructions is most important?
- A. Take the medication with food to reduce stomach upset.
- B. Report any signs of bleeding immediately.
- C. Avoid taking the medication with aspirin.
- D. Store the medication in the refrigerator.
Correct Answer: B
Rationale: Dabigatran, an anticoagulant, increases bleeding risk, so reporting signs of bleeding is critical for safety.
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The nurse is assessing a client with a suspected bowel obstruction. Which of the following findings is most indicative of this condition?
- A. Abdominal distension.
- B. Decreased bowel sounds.
- C. Soft, nontender abdomen.
- D. Frequent loose stools.
Correct Answer: A,B
Rationale: Abdominal distension and decreased bowel sounds are hallmark signs of bowel obstruction due to blocked intestinal passage.
The nurse is caring for a child with a head injury. Place the following assessments in order of priority, starting with the nursing assessment the nurse should perform first.
- A. Vital signs.
- B. Decreased urine output.
- C. Level of consciousness.
- D. Motor strength.
Correct Answer: C,A,D,B
Rationale: Level of consciousness is the priority to assess neurological status, followed by vital signs for stability, motor strength for deficits, and urine output for systemic effects.
The nurse is instructing an unlicensed assistive personnel on the prevention of postoperative pulmonary complications. Which of the following statements indicates that the assistant has understood the nurse's instructions?
- A. I will turn the client every 4 hours.'
- B. I will keep the client's head elevated.'
- C. I should suction the client every 2 hours.'
- D. I will have the client take 5 to 10 deep breaths every hour.'
Correct Answer: D
Rationale: Deep breathing exercises hourly prevent atelectasis and promote lung expansion, key to preventing pulmonary complications.
Which of the following terms is used to describe the sound, timely, smooth, unfragmented and seamless transition of the client from one level of acuity to another?
- A. Case management
- B. Continuity of care
- C. Medical necessity
- D. Critical pathway
Correct Answer: B
Rationale: Continuity of care refers to the seamless, coordinated transition of a client across different levels of care, ensuring consistent and effective treatment.
A client with a history of chronic kidney disease is prescribed calcitriol (Rocaltrol). The nurse should instruct the client to:
- A. Monitor for signs of hypercalcemia.
- B. Take the medication on an empty stomach.
- C. Avoid phosphorus-rich foods.
- D. Stop the medication if nausea occurs.
Correct Answer: A
Rationale: Calcitriol can cause hypercalcemia, requiring monitoring for symptoms like confusion.