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Which client position is contraindicated for a client with a spinal cord injury?
- A. Supine with head flat.
- B. Logrolling technique.
- C. Head elevated 30 degrees.
- D. Neutral neck alignment.
Correct Answer: A
Rationale: Supine with head flat is contraindicated as it may increase spinal pressure; other positions support alignment and safety.
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The nurse is caring for a client who has osteoarthritis. Which of the following medications should the nurse expect to be prescribed for the client?
- A. allopurinol
- B. etanercept
- C. oxaprozin
- D. methotrexate
Correct Answer: C
Rationale: Oxaprozin is a nonsteroidal anti-inflammatory drug (NSAID) commonly prescribed for osteoarthritis to reduce pain and inflammation. Allopurinol is used for gout, etanercept for autoimmune conditions like rheumatoid arthritis, and methotrexate for severe autoimmune diseases, not typically osteoarthritis.
The right hand of a client with multiple sclerosis trembles severely whenever she attempts a purposeful act, such as picking up her coffee cup or buttoning her dress. Which is the best legal documentation in nurses' notes of the chart for this client assessment?
- A. "Has an intention tremor of the right hand."
- B. "Right-hand tremor worsens with purposeful acts."
- C. "Needs assistance with dressing and eating due to severe trembling and clumsiness."
- D. "Slight shaking of right hand increases to severe tremor when client tries to button her clothes or drink from a cup."
Correct Answer: D
Rationale: The most detailed and accurate documentation is: "Slight shaking of right hand increases to severe tremor when client tries to button her clothes or drink from a cup," as it describes the intention tremor specifically and legally.
The nurse is tracking data on a group of clients with heart failure who have been discharged from the hospital and are being followed at a clinic. Which of the following data indicate that nursing interventions of monitoring and teaching have been effective?
- A. 90 percent of clients have not gained weight.
- B. 75 percent of the clients viewed the educational video.
- C. 80 percent of the clients reported that they are taking their medications.
- D. 5 percent of the clients required hospitalization in the last 90 days.
Correct Answer: A,C,D
Rationale: No weight gain (A), medication adherence (C), and low hospitalization rates (D) indicate effective management of heart failure through monitoring and teaching.
The nurse is providing education to a client who is prescribed terbinafine for onychomycosis affecting the toenails. Which statements by the client demonstrate understanding regarding the teaching about terbinafine? Select all that apply.
- A. Following a successful course of treatment, my chance of getting cured is 90%.
- B. I will have to take terbinafine for 3 to 6 months.
- C. I will need liver function tests before starting terbinafine.
- D. I will take this on an empty stomach to help improve its absorption.
- E. It may cause taste or vision changes, so I will report vision changes to my doctor.
- F. Dark urine, pale stools, and persistent nausea may indicate a serious side effect.
Correct Answer: B,C,E
Rationale: Choice B is correct; terbinafine treatment for toenail onychomycosis typically lasts 3-6 months. Choice C is correct; liver function tests are required before and during treatment due to the risk of hepatotoxicity. Choice E is correct; terbinafine can cause taste or vision changes, and vision changes should be reported. Choice A is incorrect; the cure rate is approximately 70-80%, not 90%. Choice D is incorrect; terbinafine can be taken with or without food, and an empty stomach is not required. Choice F is correct; dark urine, pale stools, and nausea may indicate liver toxicity, a serious side effect.
A client undergoing chemotherapy tells the nurse, 'I do not want to get out of bed in the morning because I am so tired.' The nursing plan of care should include:
- A. Education on the use of Neupogen (filgrastim).
- B. Individually tailored exercise program.
- C. Weight lifting when not experiencing fatigue.
- D. Bed rest until chemotherapy is completed.
Correct Answer: B
Rationale: An individually tailored exercise program can help combat fatigue, improve energy levels, and enhance quality of life for chemotherapy patients.