Nokea
Which client would be most at risk for developing varicose veins?
- A. A Caucasian female who is a nurse.
- B. An African American male who is a bus driver.
- C. An Asian female with no children.
- D. An elderly male with diabetes.
Correct Answer: A
Rationale: Nurses (A) stand for long periods, increasing varicose vein risk. Bus drivers (B) sit, nulliparity (C) is less risky, and diabetes (D) is not a direct factor.
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The male client diagnosed with essential hypertension has been prescribed an alpha-adrenergic blocker. Which intervention should the nurse discuss with the client?
- A. Eat at least one (1) banana a day to help increase the potassium level.
- B. Explain that impotence is an expected side effect of the medication.
- C. Take the medication on an empty stomach to increase absorption.
- D. Change position slowly when going from a lying to sitting position.
Correct Answer: D
Rationale: Alpha blockers cause orthostatic hypotension; changing positions slowly (D) prevents falls. Bananas (A) are unrelated, impotence (B) is possible but not expected, and empty stomach (C) is not required.
The intensive care department nurse is calculating the total intake for a client diagnosed with hypertensive crisis. The client has received 880 mL of D5W, IVPB of 100 mL of 0.9% NS, 8 ounces of water, 4 ounces of milk, and 6 ounces of chicken broth. The client has had a urinary output of 1,480 mL. What is the total intake for this client?
Correct Answer: 1180
Rationale: Total intake = IV fluids (880 mL D5W + 100 mL NS) + oral fluids (8 oz water + 4 oz milk + 6 oz broth). 1 oz = 30 mL, so oral = (8+4+6) × 30 = 540 mL. Total = 880 + 100 + 540 = 1,180 mL. Output (1,480 mL) is not included in intake.
The client diagnosed with atherosclerosis asks the nurse, 'I have heard of atherosclerosis for many years but I never really knew what it meant. Am I going to die?' Which statement would be the nurse’s best response?
- A. This disease process will not kill you, so don’t worry.'
- B. The blood supply to your brain is being cut off.'
- C. It is what caused you to have your high blood pressure.'
- D. Atherosclerosis is a buildup of plaque in your arteries.'
Correct Answer: D
Rationale: Atherosclerosis is plaque buildup in arteries (D), a clear and accurate response. It’s not always fatal (A), doesn’t primarily affect brain (B), and isn’t the sole cause of hypertension (C).
Which finding in a client with an arterial disorder indicates a worsening condition?
- A. Cool, pale skin on the affected leg
- B. Mild leg pain at rest
- C. Heart rate of 75 beats per minute
- D. Blood pressure of 125/80 mmHg
Correct Answer: A
Rationale: Cool, pale skin indicates worsening arterial insufficiency, suggesting reduced blood flow to the limb.
The nurse is caring for a client who is receiving heparin therapy intravenously. Which assessment data would indicate to the nurse the client is developing heparin-induced thrombocytopenia (HIT)? Select all that apply.
- A. The client has spontaneous bleeding from around the IV site.
- B. The client complains of chest pain on inspiration and has become restless.
- C. The client’s platelet count on admission was 420 (103) and now is 200 (103).
- D. The client complains that the gums bleed when brushing the teeth.
- E. The client has developed skin lesions at the IV site.
Correct Answer: A,C,D
Rationale: HIT causes thrombocytopenia and bleeding: IV site bleeding (A), platelet drop from 420 to 200 (C), and gum bleeding (D) are signs. Chest pain/restlessness (B) suggests PE, and skin lesions (E) are not typical.