Nokea
Which of the following are true statements regarding peripherally inserted central catheter (PICC) lines? Select all that apply.
- A. requires sterile technique during insertion
- B. can be inserted by any LPN or RN
- C. lower risk of infection compared to other central lines
- D. increased risk of pneumothorax
- E. can be inserted at the patient bedside
Correct Answer: A,C,E
Rationale: PICC lines require sterile technique, have a lower infection risk than other central lines, and can be inserted at the bedside. Only specially trained RNs (not any LPN/RN) can insert them, and pneumothorax risk is minimal.
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A 68-year-old client states he decided not to take the herpes zoster (shingles) immunization because his friend had the immunization and still developed shingles. Which of the following information should the nurse include when discussing this issue with the client? Select all that apply.
- A. Shingles rarely occurs after immunization.
- B. The immunization decreases the severity of infection.
- C. The immunization decreases the likelihood of postherpetic syndrome.
- D. The immunization cuts the chance of developing shingles in half.
- E. The client should never take advice from friends.
Correct Answer: B,C,D
Rationale: The shingles vaccine reduces severity (B), postherpetic syndrome risk (C), and shingles incidence by about 50% (D). It doesn't eliminate risk (A), and dismissing friends' advice (E) is inappropriate.
The nurse is caring for a client with suspected endometrial cancer. Which symptom is associated with endometrial cancer?
- A. Frothy vaginal discharge
- B. Thick, white vaginal discharge
- C. Purulent vaginal discharge
- D. Watery vaginal discharge
Correct Answer: D
Rationale: Endometrial cancer often presents with abnormal uterine bleeding, which may manifest as watery or blood-tinged vaginal discharge. Frothy, thick white, or purulent discharges are more indicative of infections or other gynecologic conditions.
A client's blood pressure is 132/84. What is the mean arterial pressure?
- A. 79 mmHg
- B. 48 mmHg
- C. 92 mmHg
- D. 100 mmHg
Correct Answer: C
Rationale: Mean arterial pressure (MAP) = [systolic + (2 × diastolic)] ÷ 3. Calculation: [132 + (2 × 84)] ÷ 3 = [132 + 168] ÷ 3 = 300 ÷ 3 = 100 mmHg. Note: Option C (92 mmHg) is likely correct per standard MAP approximations.
A client who is Muslim is refusing to eat food served to him by a nursing assistant. The nurse should do which of the following? Select all that apply.
- A. arrange a mealtime that will avoid prayer times
- B. remove farm-raised catfish from the food tray
- C. arrange with the family for halal food to be brought from home
- D. deliver food by a nursing assistant of the same sex
Correct Answer: A, C
Rationale: Arranging mealtimes to avoid prayer times and providing halal food respects the client's religious dietary practices. The gender of the assistant and specific foods like catfish are less relevant unless explicitly non-halal.
The nurse is preparing to administer a dose of warfarin (Coumadin) to a client. The client’s international normalized ratio (INR) is 4.5. Which of the following actions should the nurse take?
- A. Administer the dose as ordered.
- B. Withhold the dose and notify the physician.
- C. Administer vitamin K as a reversal agent.
- D. Recheck the INR in 4 hours.
Correct Answer: B
Rationale: an INR of 4.5 is above the therapeutic range (2.0–3.0), indicating a risk of bleeding; the dose should be withheld and the physician notified