Nokea
The nurse is teaching a client with a new diagnosis of heart failure about carvedilol (Coreg). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this medication with food.
- B. I should check my pulse before taking this medication.
- C. I should report dizziness to my doctor.
- D. I should stop this medication if I feel better.
Correct Answer: D
Rationale: Stopping carvedilol when feeling better is incorrect, as heart failure requires lifelong treatment to manage symptoms and prevent progression. Options A, B, and C are correct: food reduces GI upset, pulse monitoring detects bradycardia, and dizziness may indicate hypotension.
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A client comes to the clinic complaining of severe facial pain. In order to collect subjective data from the client, it is MOST important for the nurse to
- A. obtain the client's vital signs.
- B. interview the client.
- C. inspect the face for grimacing.
- D. administer pain medication.
Correct Answer: B
Rationale: subjective data is collected in the health history or interview
The nurse is caring for clients in the skilled nursing facility.
- A. Which client requires the nurse’s immediate attention?
- B. A client admitted for a cerebral vascular accident (CVA) whose prescription for warfarin (Coumadin) expired two days ago.
- C. A client in pain who was receiving morphine in an acute care institution and was transferred with a prescription for acetaminophen with codeine.
- D. A client who has dysuria and foul-smelling, cloudy, dark amber urine.
- E. An immunosuppressed client who has not received an influenza immunization.
Correct Answer: A
Rationale: A client with an expired warfarin prescription post-CVA is at high risk for recurrent stroke due to the anticoagulant’s 2-5 day duration, requiring immediate attention. Pain management, urinary symptoms, and immunization are less urgent.
A client who has been abusing alcohol and other drugs for six years. The nursing diagnosis is ineffective individual coping.
Which of the following nursing actions should take priority during the working stage of their relationship?
- A. Observe the client every half-hour to determine the extent of drug-seeking behavior.
- B. Monitor the intake of fluids, meals, and snacks to ensure adequate nutrition.
- C. Help the client obtain a sponsor through a 12-step group in the client's local area.
- D. Meet individually with the client to discuss the consequences of drug-using behavior and examine other options.
Correct Answer: D
Rationale: Strategy: Answers are a mix of assessments and implementations. Are the assessments appropriate? No. Determine the outcome of the implementations. (1) assessment, important in the assessment phase of the relationship (2) assessment, important for a different nursing diagnosis (3) implementation, will be important in discharge planning (4) correct-implementation, describes the work of the interpersonal relationship with a chemically dependent client; goal is to get client to recognize problems the chemicals have caused and to learn new methods of solving problems
The nurse is caring for a postoperative patient. Four hours after surgery, the patient voids 200 cc of urine with a specific gravity of 1.019. The nurse should
- A. palpate the patient's lower abdomen for distention.
- B. encourage an increased intake of oral fluids.
- C. record the time and the amount of urine.
- D. encourage the patient to void again in two hours.
Correct Answer: C
Rationale: amount and specific gravity normal (1.010-1.030)
An abdominal wound irrigation with a normal saline solution is ordered for a client. To perform this procedure, the nurse should
- A. warm the irrigating solution to 110°F (43.3°C).
- B. establish a sterile field that includes the irrigating equipment.
- C. direct the irrigating solution at the outer edges of the wound, then the center of the wound.
- D. aspirate the irrigating fluid with a syringe to prevent accumulation in the wound.
Correct Answer: B
Rationale: requires strict aseptic technique