Nokea
The nurse receives emergency laboratory results for a client with chest pain and immediately informs the physician. An increased myoglobin level suggests which of the following?
- A. Cancer.
- B. Hypertension.
- C. Liver disease.
- D. Myocardial damage.
Correct Answer: D
Rationale: Elevated myoglobin indicates myocardial damage, as it is released from injured cardiac muscle, supporting a diagnosis of MI.
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A nurse is treating a client who came to the emergency department after getting bit by a snake on their arm. After confirming the resuscitation equipment is at the bedside, which of the following actions by the nurse would be a priority?
- A. Contact Poison Control for guidance on an antivenom.
- B. Ensure the client's peripheral intravenous (IV) lines are patent.
- C. Apply a tourniquet above the snake bitten area on the arm.
- D. Assess for rash, fever, chills, nausea, vomiting, and joint pain.
Correct Answer: B
Rationale: Ensuring patent IV lines is the priority to enable rapid antivenom or fluid administration, critical for snakebite management. Contacting Poison Control (A) is secondary, tourniquets (C) are harmful, and symptom assessment (D) is important but not the immediate priority.
A client has undergone an amputation of several toes and a femoral-popliteal bypass. The nurse should teach the client that after surgery which of the following leg positions is contraindicated for her while sitting in a chair?
- A. Crossing the legs
- B. Elevating the legs
- C. Flexing the ankles
- D. Extending the knees
Correct Answer: A
Rationale: Crossing the legs is contraindicated post-femoral-popliteal bypass and toe amputation, as it compresses blood vessels, impairing circulation and increasing the risk of graft occlusion or ischemia. Elevating legs, flexing ankles, and extending knees are generally acceptable unless otherwise specified.
Cushing's disease is manifested by the excessive secretion of corticosteroids. The hormones involved are:
- A. Glucocorticoids and aldosterone.
- B. Adrenocorticotropic hormone (ACTH).
- C. Glucocorticoids, aldosterone, and androgens.
- D. Catecholamines.
Correct Answer: C
Rationale: Cushing's disease involves excess glucocorticoids, aldosterone, and androgens due to adrenal hypersecretion.
The nurse is planning to teach incisional care to a client before discharge. Which of the following instructions should be included?
- A. Do not touch your incision before your next appointment.
- B. Clean your incision three times a day with hydrogen peroxide and water.
- C. Do not be concerned about uneven lumps under the suture lines.
- D. If the staples don't come out by themselves before your next appointment, the surgeon will remove them.
Correct Answer: C
Rationale: Uneven lumps under suture lines are normal due to tissue healing and swelling. This reassurance prevents unnecessary worry. Hydrogen peroxide is not routinely recommended, and staples are typically removed by the surgeon.
A client who had a serious head injury with increased intracranial pressure is to be discharged to a rehabilitation facility. Which of the following rehabilitation outcomes would be appropriate for the client? The client will:
- A. Exhibit no further episodes of short-term memory loss.
- B. Be able to return to his construction job in 3 weeks.
- C. Actively participate in the rehabilitation process as appropriate.
- D. Re campaign to the end display pre-injury personality traits.
Correct Answer: C
Rationale: Active participation in rehabilitation is a realistic and appropriate outcome, promoting recovery tailored to the client's abilities. Eliminating memory loss, returning to a physically demanding job soon, or fully restoring pre-injury personality are unrealistic due to the severity of the injury.