Nokea
Which client is at greatest risk for complications following abdominal surgery?
- A. A 68-year-old obese client with noninsulin-dependent diabetes
- B. A 27-year-old client with a recent history of urinary tract infections
- C. A 16-year-old client who smokes a half-pack of cigarettes per day
- D. A 40-year-old client who exercises regularly, with no history of medical conditions
Correct Answer: A
Rationale: Obesity and diabetes increase the risk of surgical complications like infection and poor wound healing.
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When assessing a laboring client, the nurse finds a prolapsed cord. The nurse should:
- A. Attempt to replace the cord
- B. Place the client on her left side
- C. Elevate the client's hips
- D. Cover the cord with a dry, sterile gauze
Correct Answer: C
Rationale: Elevating the hips relieves pressure on the prolapsed cord, maintaining fetal oxygenation.
The nurse plans on administering a medication using the Z-track intramuscular technique. The nurse knows the following steps are required during the procedure. Select all that apply.
- A. Draw 0.2-0.5 cc of air after aspirating the prescribed medication.
- B. Use the vastus lateralis muscle.
- C. Replace the needle used for medication withdrawal with a new one prior to injection.
- D. Insert the needle at 45-degree angle.
Correct Answer: A,C
Rationale: Z-track requires an air lock (A) to seal medication and a new needle (C) to prevent tracking. The needle is inserted at 90 degrees, not 45 (D), and various muscles can be used (B is not mandatory).
A 6-month-old is hospitalized with symptoms of botulism. What aspect of the infant's history is associated with Clostridium botulinum infection?
- A. The infant sucks on his fingers and toes.
- B. The mother sweetens the infant's cereal with honey.
- C. The infant was switched to soy-based formula.
- D. The father recently purchased an aquarium.
Correct Answer: B
Rationale: Honey can contain Clostridium botulinum spores, which are a common cause of infant botulism in children under 12 months, as their digestive systems cannot eliminate the spores.
The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed for the client. Which of the following in the client's history should be reported to the doctor?
- A. Diabetes
- B. Prinzmetal's angina
- C. Cancer
- D. Cluster headaches
Correct Answer: B
Rationale: Prinzmetal's angina is a contraindication for sumatriptan due to the risk of coronary vasospasm, and this should be reported to the doctor.
The nurse has received report on the day's assigned clients. Which of the following clients should the nurse see first?
- A. a client who is post-op day 2 from a spinal fusion at L34 with a pain level of 4 on a scale of 1-10
- B. a client with a peripheral IV on a 6-hour infusion with 42 cc remaining
- C. a client who is 6 hours post-atrial fibrillation ablation, is agitated, has a HR of 130 with B/P at 90/50, and has a urine output of 30 cc in the last 2 hours
- D. a client with a nasogastric tube in place who is complaining of gastric distress
Correct Answer: C
Rationale: The client post-atrial fibrillation ablation with agitation, tachycardia (HR 130), hypotension (BP 90/50), and low urine output (30 cc in 2 hours) indicates potential instability, requiring immediate assessment. This takes priority over stable post-op pain, an IV with remaining fluid, or gastric distress.