Nokea
Which of the following abnormal serum chemistry results is a client with cirrhosis who has developed ascites likely to have?
- A. Decreased aspartate aminotransferase.
- B. Hypoalbuminemia.
- C. Hyperkalemia.
- D. Decreased alanine aminotransferase.
Correct Answer: B
Rationale: Cirrhosis impairs liver protein synthesis, leading to hypoalbuminemia, which causes ascites due to decreased oncotic pressure.
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Before discharge from the hospital after a myocardial infarction, a client is taught to exercise by gradually increasing the distance walked. Which vital sign should the nurse teach the client to monitor to determine whether to increase or decrease the exercise level?
- A. Pulse rate.
- B. Blood pressure.
- C. Body temperature.
- D. Respiratory rate.
Correct Answer: A
Rationale: Monitoring pulse rate helps determine if the exercise level is appropriate, as an excessively high rate indicates overexertion.
The nurse is caring for a client at risk for suicide. Which client behavior best indicates that the client may be contemplating suicide?
- A. Sharing that she or he is finally happy
- B. Sitting and crying for long periods of time
- C. Preferring to spend long periods of time alone
- D. Reporting a variety of sleep pattern disturbances
Correct Answer: A
Rationale: If a client displays a suicidal ideation and is able to share a plan, it should be taken very seriously and suicide precautions should be implemented. Expressing happiness shows a contentment that is often a sign that a suicide plan has been created. The remaining options are indicative of depression but are not as definitive in regard to suicide.
When the nurse is assessing a client's cultural adaptation, which of the following statements is least sensitive to the client's needs?
- A. What are some of your favorite foods?'
- B. Describe any health problems in your past.'
- C. Please tell me how you would like to be addressed.'
- D. Your eyes look dark; is this normal for you?'
Correct Answer: D
Rationale: Commenting on the client's appearance (dark eyes) is insensitive and irrelevant to cultural adaptation, potentially making the client uncomfortable.
A client with a diagnosis of polycythemia vera is prescribed hydroxyurea (Hydrea). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Bone marrow suppression.
- C. Hyperkalemia.
- D. Weight gain.
Correct Answer: B
Rationale: Hydroxyurea can cause bone marrow suppression, requiring monitoring of blood counts for anemia or leukopenia.
The nurse is assessing a teenage girl. According to the fi gure below, the nurse should note that the girl has:
- A. Kyphosis.
- B. Arthritis.
- C. Developmental dysplasia of the hip.
- D. Scoliosis.
Correct Answer: D
Rationale: The teenage girl has scoliosis, the lateral deviation of the spine. Kyphosis is noted by a forward curvature of the shoulders. Arthritis is diagnosed by radiographs. Hip dysplasia is noted in older children by pain, but is usually diagnosed before the child walks by noting excessive gluteal folds and limited hip abduction.