Nokea
What are clinical manifestations of insomnia (select all that apply)?
- A. Narcolepsy
- B. Fragmented sleep
- C. Long sleep latency
- D. Morning headache
Correct Answer: B
Rationale: The correct answers are B, C, and F. Fragmented sleep, long sleep latency, and difficulty concentrating are common symptoms of insomnia. Narcolepsy (A) is unrelated, morning headache (D) can occur but is less common, and daytime sleepiness (E) is more typical of sleep apnea.
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Yesterday, a male client had a transurethral resection of the prostate (TURP). Today, the client is concerned about the small amount of blood found in his urine. The nurse should explain to the client that the blood:
- A. should not be there on the second day.
- B. will stop when the Foley catheter is removed.
- C. is normal and he should not be concerned.
- D. can be removed by irrigating the bladder.
Correct Answer: C
Rationale: Some hematuria is usual for several days after surgery. The client should not be concerned, unless the amount increases. The client will continue to have a small amount of hematuria even after the Foley catheter is removed. Some hematuria is usual for several days after surgery. The client should not be concerned, unless the amount increases. Irrigating the bladder will not remove the hematuria. Irrigation is performed to remove blood clots and to facilitate urinary drainage.
Joan is diagnosed with a ruptured aneurysm. She wonders why this was not picked up in her annual physical. You respond by saying
- A. The physician must have misread the x-ray.
- B. The aneurysm must have developed since the physical.
- C. Aneurysms are often asymptomatic.
- D. Do not be too concerned because this happens all the time.
Correct Answer: C
Rationale: Aneurysms can develop silently without noticeable symptoms.
What would be the best response by the nurse to a quiet and uncommunicative client?
- A. Think over the following questions.
- B. Discuss them with your instructor or peers.
- C. Acknowledge their feelings and encourage expression.
- D. Offer silence and wait patiently.
Correct Answer: D
Rationale: Silence can provide the client with space to open up when they feel ready, fostering trust and rapport.
Following chemotherapy, a patient is being closely monitored for tumor lysis syndrome. Which laboratory value requires particular attention?
- A. Platelet count.
- B. Electrolytes.
- C. Hemoglobin.
- D. Hematocrit.
Correct Answer: B
Rationale: Electrolyte imbalances, particularly hyperkalemia and hyperuricemia, are hallmark features of tumor lysis syndrome and must be closely monitored.
A client with chronic obstructive pulmonary disease is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?
- A. Eat 3 balanced meals each day.
- B. Limit fluid intake with meals.
- C. Reduce sodium intake.
- D. Take a bronchodilator 1 hour before eating.
Correct Answer: B
Rationale: The correct answer is B: Limit fluid intake with meals. This instruction is important for a client with COPD because excessive fluid intake during meals can lead to increased stomach distention, which can worsen breathing difficulties. By limiting fluid intake with meals, the client can reduce the risk of feeling bloated and experiencing shortness of breath.
A: Eating 3 balanced meals each day is generally a good recommendation, but it does not specifically address the needs of a client with COPD.
C: Although reducing sodium intake can be beneficial for managing COPD, it is not as directly related to dietary considerations during meals.
D: Taking a bronchodilator 1 hour before eating is not a dietary instruction and does not address the issue of fluid intake during meals.