Nokea
The nurse provides discharge instructions to a client after implantation of a permanent pacemaker. The nurse should instruct the client to avoid exposure to which item?
- A. Hair dryers
- B. Electric blankets
- C. Electric toothbrushes
- D. Airport metal detectors
Correct Answer: D
Rationale: A pacemaker is shielded from interference from most electrical devices. Devices to be forewarned about include those with a strong electric current or magnetic field, such as antitheft devices in stores, metal detectors used in airports, and radiation therapy (if applicable and which might require relocation of the pacemaker). Radios, televisions, electric blankets, toasters, microwave ovens, heating pads, and hair dryers are considered to be safe.
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A client with severe major depression states, 'My heart has stopped and my blood is black ash.' The nurse interprets this statement to be evidence of which of the following?
- A. Hallucination.
- B. Illusion.
- C. Delusion.
- D. Paranoia.
Correct Answer: C
Rationale: The client's statement reflects a false, fixed belief that is not based in reality, which is characteristic of a delusion. Hallucinations involve sensory perceptions, illusions are misinterpretations of stimuli, and paranoia involves suspicion, none of which fit this scenario.
When performing an assessment on a mother who just delivered a healthy newborn, the nurse should expect to note that the fundus is positioned at which location?
- A. To the right of the abdomen
- B. At the level of the umbilicus
- C. Above the level of the umbilicus
- D. One fingerbreadth above the symphysis pubis
Correct Answer: B
Rationale: Immediately after delivery, the uterine fundus should be at the level of the umbilicus or one to three fingerbreadths below it and in the midline of the abdomen. A fundus that is not located in the midline may indicate a full bladder. If the fundus is above the umbilicus, this may indicate that blood clots in the uterus need to be expelled by fundal massage.
A nurse is assessing an 82-year-old for depression, because of the client's age, the nurses' assessment should be guided by the fact that:
- A. Sadness of mood is usually present but it is masked by other symptoms.
- B. Impairment of cognition usually is not present.
- C. Psychosomatic tendencies do not tend to dominate.
- D. Antidepressant therapies are less effective in older adults.
Correct Answer: A
Rationale: In older adults, depression may present with atypical symptoms, such as somatic complaints or irritability, rather than overt sadness, which can mask the condition.
The nurse is caring for a client with a history of epilepsy who is prescribed valproic acid (Depakene). Which of the following laboratory tests should the nurse monitor?
- A. Liver function tests.
- B. Renal function tests.
- C. Complete blood count.
- D. Blood glucose levels.
Correct Answer: A
Rationale: Valproic acid can cause hepatotoxicity, requiring regular monitoring of liver function tests.
The nurse is preparing to give a subcutaneous injection to an elderly, emaciated client. Which needle length and angle should the nurse plan to use to administer the injection safely?
- A. A 3/8-inch needle at a 90-degree angle.
- B. A 3/8-inch needle at a 45-degree angle.
- C. A 1/2-inch needle at a 15-degree angle.
- D. A 5/8-inch needle at a 90-degree angle.
Correct Answer: B
Rationale: For an emaciated client, a 3/8-inch needle at a 45-degree angle ensures subcutaneous delivery without hitting muscle or bone.