Nokea
The nurse is teaching a client with a new diagnosis of rheumatoid arthritis about medication management. Which of the following medications should the client expect to take?
- A. Methotrexate.
- B. Colchicine.
- C. Allopurinol.
- D. Probenecid.
Correct Answer: A
Rationale: Methotrexate is a disease-modifying antirheumatic drug (DMARD) commonly used for rheumatoid arthritis.
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Which client should the nurse delegate to the unlicensed assistive personnel (UAP)?
- A. A client who needs teaching regarding the use of an incentive spirometer
- B. A client who needs to have a urine specimen collected for a clean catch urine
- C. A client who needs reinforcement of a dressing covering an abdominal incision
- D. A client who needs assessment of a newly identified area of pressure over the right hip
Correct Answer: B
Rationale: The UAP can assist with specimen collection such as a clean catch urine because he or she is trained in this skill. Skills requiring nursing intervention such as dressing changes, teaching, and assessment cannot be delegated to unlicensed personnel.
The nurse is monitoring a client with a diagnosis of chronic kidney disease (CKD). Which assessment finding should the nurse report to the primary health care provider?
- A. Pallor
- B. Fatigue
- C. Lethargy
- D. Petechiae
Correct Answer: D
Rationale: CKD can cause damage to many body systems. Hematological manifestations that can occur with this disease include anemia and bleeding. Abnormal bleeding (petechiae; purpura; bruising; bleeding from the mucous membranes, nose, or gums; vaginal bleeding; or intestinal bleeding) should be reported to the primary health care provider because it can be life-threatening. Pallor, fatigue, and lethargy are clinical manifestations associated with anemia.
Which of the following should be the nurse's priority assessment after an epidural anesthetic has been administered to a client in labor?
- A. Level of consciousness.
- B. Blood pressure.
- C. Cognitive function.
- D. Contraction pattern.
Correct Answer: B
Rationale: Epidurals can cause hypotension due to vasodilation, making blood pressure the priority assessment.
A nurse who fails to check a client's armband before administering his medications is:
- A. Negligent.
- B. Following standard procedure.
- C. Acting within their scope of practice.
- D. Exercising professional judgment.
Correct Answer: A
Rationale: Failing to check a client's armband before administering medications is negligent, as it violates patient safety protocols for verifying identity.
A 56-year-old woman is admitted for a modified radical mastectomy. The client appears anxious and asks many questions. The nurse's best course of action is to:
- A. Tell the client as much as she wants to know and is able to understand.
- B. Delay discussing the client's questions with her until the convalescent phase of her care.
- C. Delay discussing the client's questions with her until her apprehension subsides.
- D. Explain to the client that she should discuss her questions with her physician.
Correct Answer: A
Rationale: Addressing the client's questions thoroughly and at her level of understanding reduces anxiety and supports informed consent.