Nokea
The nurse provides instructions to a client about applying a nitroglycerin patch. What statement indicates that the client is using correct technique?
- A. A second patch will be applied if chest pain occurs.
- B. I will apply the patch to a nonhairy area of the body.
- C. I will remove the patch when bathing and reapply it after the bath.
- D. I will remove the patch after gently rubbing the area to activate the medication.
Correct Answer: B
Rationale: Topical nitroglycerin is applied to a nonhairy part of the body. It is used on a scheduled basis and is not prescribed specifically for the occurrence of chest pain. The ointment is not rubbed into the skin; it is reapplied only as directed.
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The student nurse is listening to an orthopedic lecture on preoperative education and knee surgeries. Which statement by the student nurse indicates that the teaching has been effective?
- A. Crutch walking instructions should be scheduled before surgery.
- B. Crutch walking instructions should be given on the first postoperative day.
- C. Crutch walking instructions should be scheduled on the second postoperative day.
- D. Crutch walking instructions should be scheduled at the time of discharge after surgery.
Correct Answer: A
Rationale: It is best to assess crutch-walking ability and instruct the client with regard to the use of the crutches before surgery because this task can be difficult to learn when the client is in pain and not used to the imbalance that may occur after surgery. None of the remaining options are appropriate times to teach a client about crutch walking.
A client with a short leg plaster cast reports intense itching under the cast. The nurse provides instructions to the client regarding relief measures for the itching. Which statement by the client indicates an understanding of the measures used to relieve the itching?
- A. I can use the blunt part of a ruler to scratch the area.
- B. I can trickle small amounts of water down inside the cast.
- C. I need to obtain assistance when placing an object into the cast for the itching.
- D. I can use a hair dryer on the low setting and allow the air to blow into the cast.
Correct Answer: D
Rationale: Itching is a common complaint of clients with casts. Objects should not be put inside a cast because of the risk of scratching the skin and providing a point of entry for bacteria. A plaster cast can break down when wet. Therefore, the best way to relieve itching is with the forceful injection of air inside the cast.
The nurse is giving medication instructions to a client who is receiving furosemide. Which client statement indicates a need for further teaching?
- A. I need to change positions slowly.
- B. I need to be careful to not get overheated in warm weather.
- C. I need to talk to my primary health care provider about the use of alcohol.
- D. I need to avoid the use of salt substitutes because they contain potassium.
Correct Answer: D
Rationale: Furosemide is a potassium-losing diuretic, so there is no need to avoid high-potassium products, such as a salt substitute. Orthostatic hypotension is a risk, and the client must use caution when changing positions and with exposure to warm weather. The client needs to discuss the use of alcohol with the primary health care provider.
The nurse is educating the client on how to save lives and prevent burn injuries, in the event of a fire in the home. Which statement by the client indicates that the teaching has been effective?
- A. I should lace escape ladders in the bedrooms.
- B. I should install a whole-house sprinkler system.
- C. I should keep fresh batteries in smoke detectors.
- D. I should mount fire extinguishers in several areas.
Correct Answer: C
Rationale: The early detection of smoke using a smoke detector and immediate evacuation from the house have significant and positive effects on mortality rates. This is because the smoke alarm activates before the appearance of open flames, which gives people in the house a chance to evacuate without burn injuries. Option 1 helps people in the house escape from second-story rooms safely, but it does not alert the people to the fire before flames are evident, thus exposing them to the risk of burn injury. Installing a sprinkler system is very expensive, and this is usually not done in private residences. Fire extinguishers are a good idea to have in the kitchen and other areas for small fires, but they are not designed to extinguish large fires.
A client has been prescribed a clonidine patch, and the nurse has instructed the client regarding the use of the patch. Which client statement indicates a need for further teaching?
- A. I intend to change the patch every 7 days.
- B. I need to trim the patch if an edge becomes loose.
- C. It's important to put the patch on a hairless site on my torso.
- D. It's alright to leave the patch in place during bathing or showering.
Correct Answer: B
Rationale: The clonidine patch should not be trimmed because it will alter the medication dose. If it becomes slightly loose, it should be covered with an adhesive overlay from the medication package. If it becomes very loose or falls off, it should be replaced. It is changed every 7 days, and is left in place when bathing or showering. The clonidine patch should be applied to a hairless site on the torso or the upper arm. The patch is discarded by folding it in half with the adhesive sides together.