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An arthritic client must be able to perform tasks to manage at home alone following discharge from the hospital.
The nurse knows that to manage at home alone following discharge from the hospital, an arthritic client must be able to perform which of the following tasks?
- A. Climb up and down stairs.
- B. Lace and tie his/her shoes.
- C. Comb his/her hair and brush his/her teeth.
- D. Walk without assistance.
Correct Answer: C
Rationale: Strategy: Think about the significance of each answer choice and how it relates to arthritis. (1) stairs can be eliminated in the client's environment (2) is a modifiable problem with the use of slip-on shoes (3) correct-is part of basic hygiene and grooming that must be done daily to maintain overall health (4) is not necessary for independence; walker or wheelchair may be used
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An adult is admitted with histoplasmosis. What is most likely to be in the client's history because he has histoplasmosis?
- A. He is a chicken farmer.
- B. He ate raw shellfish recently.
- C. He consumed contaminated water.
- D. He drinks raw milk.
Correct Answer: A
Rationale: Histoplasmosis is caused by inhaling Histoplasma spores, often found in bird or bat droppings, common in chicken farming environments, unlike shellfish, water, or milk.
The nurse is caring for a client with a history of schizophrenia who is receiving haloperidol (Haldol) 5 mg PO bid. Which of the following client statements would be of GREATest concern to the nurse?
- A. I feel stiff when I walk.
- B. I have a dry mouth.
- C. I feel sleepy in the afternoon.
- D. I have a headache sometimes.
Correct Answer: A
Rationale: Stiffness when walking suggests extrapyramidal symptoms (EPS), a serious side effect of haloperidol, requiring evaluation for possible dose adjustment or antiparkinsonian medication. Options B, C, and D are common, less urgent side effects: dry mouth, sedation, and headaches.
The triage nurse for a women's health center receives a phone call from each of the following women.
Which woman should be directed to come to the health care facility IMMEDIATELY?
- A. A multipara woman who is four weeks pregnant and reporting unilateral, dull abdominal pain.
- B. A primipara woman who is seven weeks pregnant and reporting an increase in whitish vaginal secretions.
- C. A primigravida woman who is five weeks gestation and is having vaginal spotting and some cramping.
- D. A multigravida woman who is six weeks pregnant and reporting frank, red vaginal bleeding with moderate cramps.
Correct Answer: A
Rationale: Strategy: Determine the least stable client. (1) correct-needs to be evaluated for an ectopic pregnancy (2) expect during first trimester of pregnancy (3) symptomatic of threatened abortion; instruct to decrease activity (4) symptoms of spontaneous abortion; instruct client to save and count pads
A newly admitted client is exhibiting signs of severe anxiety. She is pacing back and forth and has difficulty concentrating on the nurse's questions. What nursing action is most appropriate at this time?
- A. Tell the client to sit down and get control of herself
- B. Leave the room until she regains control
- C. Whisper to her that everything will be all right
- D. Attend to her behavior and direct her to a quiet area
Correct Answer: D
Rationale: Directing the client to a quiet area reduces stimuli, helping manage severe anxiety. Commands, leaving, or whispering are ineffective or dismissive.
A clinic nurse is taking a health history from a 34-year-old man newly diagnosed with Buerger's disease. The nurse would expect the client's complaints to include
- A. heart palpitations.
- B. dizziness when walking.
- C. blurred vision.
- D. digital sensitivity to cold.
Correct Answer: D
Rationale: vasculitis of blood vessels in upper and lower extremities