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The teaching plan for the client with rheumatoid arthritis includes rest promotion. Which of the following would the nurse expect to instruct the client to avoid during rest periods?
- A. Proper body alignment.
- B. Elevating the part.
- C. Prone lying positions.
- D. Positions of flexion.
Correct Answer: D
Rationale: Positions of flexion can exacerbate joint stiffness and deformity in rheumatoid arthritis. Proper alignment, elevation, and prone positions (if comfortable) support joint health.
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A client is taking an antacid for treatment of a peptic ulcer. Which of the following statements best indicates that the client understands how to correctly take the antacid?
- A. I should take my antacid at the same time as my other medications.'
- B. I need to decrease my intake of fluids so that I don't dilute the effects of my antacid.'
- C. My antacid will be most effective if I take it whenever I experience stomach pains.'
- D. It is best for me to take my antacid 1 to 3 hours after meals.'
Correct Answer: D
Rationale: Antacids are most effective when taken 1 to 3 hours after meals, as they neutralize gastric acid during peak acid secretion. Taking antacids with other medications can interfere with absorption, and fluid intake does not need to be restricted.
The client has a nursing diagnosis of Self-care deficit related to the confinement of traction. Which of the following would indicate a successful outcome for this diagnosis?
- A. The client assists as much as possible in his care, demonstrating increased participation over time.
- B. The client allows the nurse to complete his care in an efficient manner without interfering.
- C. The client allows his wife to assume total responsibility for his care.
- D. The client allows his wife to complete his care to promote feelings of usefulness.
Correct Answer: A
Rationale: Increased participation in self-care indicates progress toward independence despite traction limitations.
The nurse has reinforced education at a conference on intramuscular (IM) injections. Which of the following statements by the participant would indicate a correct understanding of the teaching?
- A. "1 mL is the maximum volume in a single site for small children and older infants."
- B. "Depress the plunger as the needle is being inserted into the client's skin to minimize discomfort."
- C. "Insert the needle quickly using a dart-like motion at a 60-degree angle."
- D. "Injecting in the ventrogluteal muscle is more painful than the vastus lateralis."
Correct Answer: A
Rationale: The maximum volume for IM injections in small children and older infants is 1 mL to prevent tissue damage; other options contain incorrect techniques or assumptions.
Which of the following nursing assessment findings indicates hypovolemic shock in a client who has had a 15% blood loss?
- A. Pulse rate less than 60 bpm.
- B. Respiratory rate of 4 breaths/minute.
- C. Pupils unequally dilated.
- D. Systolic blood pressure less than 90 mm Hg.
Correct Answer: D
Rationale: A 15% blood loss can cause hypovolemic shock, with early signs including hypotension (systolic BP <90 mm Hg) due to reduced circulating volume. Bradycardia, low respiratory rate, and unequal pupils are not typical findings.
When teaching a client to deep breathe effectively after a lobectomy, the nurse should instruct the client to do which of the following?
- A. Occurnt the abdominal muscles, take a slow deep breath through the nose and hold it for 3 to 5 seconds, then exhale.
- B. Contract the abdominal muscles, take a deep breath through the mouth, and exhale slowly as if trying to blow out a candle.
- C. Relax the abdominal muscles, take a slow deep breath through the nose, and hold it for 3 to 5 seconds.
- D. Relax the abdominal muscles, take a deep breath through the mouth, and exhale slowly over 10 seconds.
Correct Answer: C
Rationale: Effective deep breathing post-lobectomy involves relaxing abdominal muscles, taking a slow nasal breath, holding it 3–5 seconds, and exhaling to expand lungs. Contracting muscles or mouth breathing is less effective.