Nokea
The nurse would teach a client with Raynaud's phenomenon that, after smoking cessation, it is most important to
- A. Avoid caffeine
- B. Keep feet dry
- C. Reduce stress
- D. Wear gloves
Correct Answer: A
Rationale: Avoid caffeine. Caffeine can trigger vasoconstriction, exacerbating Raynaud's phenomenon symptoms, making it a priority after smoking cessation.
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The practical nurse is assisting the registered nurse during admission of a client with heart failure-related fluid overload. Which action should be completed first?
- A. Administer oxygen
- B. Assess the client's breath sounds
- C. Initiate cardiac monitoring
- D. Insert a peripheral IV catheter
Correct Answer: B
Rationale: Assessing breath sounds is the first step to evaluate the extent of fluid overload and guide interventions in heart failure. Oxygen , monitoring , and IV insertion follow based on findings.
A client comes to the emergency department for the second time with shortness of breath and substernal pressure that radiates to the jaw. The nurse understands that angina pectoris may be precipitated by which of these factors? Select all that apply.
- A. Amphetamine use
- B. Cigarette smoking
- C. Cold exposure
- D. Deep sleep
- E. Sexual intercourse
Correct Answer: A,B,C,E
Rationale: Angina can be triggered by amphetamines increasing cardiac demand, smoking causing vasoconstriction, cold exposure inducing vasospasm, and sexual intercourse raising heart rate. Deep sleep typically reduces demand.
Laboratory reference ranges
Hemoglobin
Male: 14.0–18.0 g/dL
(140–180 g/L)
Female: 12.0–16.0 g/dL
(120–160 g/L)
WBC
5000–10,000/mm³
(5–10 × 10⁹/L)
The nurse is collecting data from a client with acute diverticulitis. Which of the following findings would be essential to follow up?
- A. abdominal pain has progressed to the left upper quadrant
- B. hemoglobin of 11.2 g/dL (112 g/L)
- C. lying on side with knees drawn up to abdomen and trunk flexed
- D. WBC count of 12,000/mm³ (12 x 10â¹/L)
Correct Answer: A
Rationale: Pain progressing to the left upper quadrant in diverticulitis is concerning for complications like perforation or abscess, requiring follow-up. Mild anemia and flexed positioning are common, and a moderately elevated WBC is expected in acute inflammation.
When counseling a 6 year-old who is experiencing enuresis, what must the nurse understand about the pathophysiological basis of this disorder?
- A. It has no clear etiology
- B. Enuresis may be associated with sleep phobia
- C. It has a definite genetic link
- D. Enuresis is a sign of willful misbehavior
Correct Answer: A
Rationale: It has no clear etiology. Enuresis has multiple contributing factors, but no single definitive cause has been established.
A client with metabolic acidosis associated with diabetes mellitus is admitted to the unit. A blood glucose of $250 \mathrm{mg} / \mathrm{dl}$ is present. Which symptom will most likely accompany ketoacidosis?
- A. Oliguria
- B. Polydipsia
- C. Perspiration
- D. Tremors
Correct Answer: B
Rationale: Diabetic ketoacidosis (DKA) causes dehydration due to hyperglycemia, leading to polydipsia (excessive thirst). Oliguria may occur later, perspiration is not specific, and tremors are more associated with hypoglycemia.