Nokea
The nurse is teaching a client with a new diagnosis of atrial fibrillation about warfarin (Coumadin) therapy. Which of the following statements by the client indicates a need for further teaching?
- A. I will avoid eating large amounts of spinach.
- B. I will report any signs of bleeding to my doctor.
- C. I will take my medication at the same time each day.
- D. I will stop taking the medication if I feel dizzy.
Correct Answer: D
Rationale: warfarin should not be stopped without medical advice, as it increases the risk of clotting
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A nurse assessing a client charts his blood pressure as 134/86. The pulse pressure would be
- A. 48
- B. 86
- C. 220
- D. 96
Correct Answer: A
Rationale: Pulse pressure is calculated as systolic BP minus diastolic BP: 134 - 86 = 48 mmHg.
An obstetrical client with diabetes has an amniocentesis at 28 weeks gestation. Which test indicates the degree of fetal lung maturity?
- A. Alpha-fetoprotein
- B. Estriol level
- C. Indirect Coomb's
- D. Lecithin sphingomyelin ratio
Correct Answer: D
Rationale: The lecithin-sphingomyelin (L/S) ratio assesses fetal lung maturity by measuring surfactant levels, critical for preterm delivery planning in diabetic pregnancies.
Each staff person has an individual password that allows access to electronic health records. Under which of the following circumstances should a nurse allow another staff person to use his/her password?
- A. A physician asks to use the password to access records of a former client.
- B. Another nurse asks to use the password because he has forgotten his own.
- C. The nurse's supervisor asks to use the password to access client records.
- D. The nurse should not allow anyone else to use the password, regardless of circumstances.
Correct Answer: D
Rationale: Passwords must not be shared (D) to protect patient confidentiality and comply with HIPAA. Sharing with a physician (A), nurse (B), or supervisor (C) is unauthorized.
A vaginal exam reveals a breech presentation in a newly admitted client. The nurse should take which of the following actions at this time?
- A. Prepare the client for a caesarean section
- B. Apply the fetal heart monitor
- C. Place the client in the Trendelenburg position
- D. Perform an ultrasound exam
Correct Answer: B
Rationale: Applying the fetal heart monitor assesses fetal well-being in a breech presentation, guiding further management.
Arterial ulcers are best described as ulcers that:
- A. Are smooth in texture
- B. Have irregular borders
- C. Are cool to touch
- D. Are painful to touch
Correct Answer: D
Rationale: Arterial ulcers are typically painful due to poor blood flow and tissue ischemia.