Nokea
Which of the following explains the influence of aging on the development of peripheral vascular disease?
- A. Decreased resistance
- B. Increased resistance
- C. Decreased viscosity
- D. Increased viscosity
Correct Answer: B
Rationale: Aging increases vascular resistance due to arterial stiffening and reduced elasticity from collagen buildup and atherosclerosis. This elevates blood pressure and impairs peripheral blood flow, contributing to PVD. Resistance does not decrease, and viscosity changes are less significant in aging-related PVD.
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A client who underwent a left lower lobectomy has been out of surgery for 48 hours. She is receiving morphine sulfate via a patient-controlled analgesia (PCA) system. She tells the nurse that she has some pain in her left thorax that worsens when she coughs. The nurse should:
- A. I don't be silent, so that she is not stimulated to cough.
- B. Encourage the client to take deep breaths to help control the pain.
- C. Check that the PCA device is functioning properly, and then reassure the client that the machine is working and will relieve her pain.
- D. Obtain a more detailed assessment of the client's pain using a pain scale.
Correct Answer: D
Rationale: A detailed pain assessment using a scale clarifies the pain's severity and guides adjustments to analgesia. Silencing the client or encouraging deep breaths may worsen pain. Checking the PCA is appropriate but secondary to assessment.
What should the nurse do first when a client with a head injury begins to have clear drainage from his nose?
- A. Compress the nares.
- B. Tilt the head back.
- C. Give the client tissues to collect the fluid.
- D. Administer an antihistamine for postnasal drip.
Correct Answer: C
Rationale: Clear drainage from the nose after a head injury may indicate cerebrospinal fluid (CSF) leakage, a serious condition. The priority is to collect the fluid for analysis to confirm CSF and avoid infection, making providing tissues the first action. Compressing the nares or tilting the head back could increase intracranial pressure or contaminate the fluid, and an antihistamine is inappropriate without confirming the cause.
A client is to be discharged with a prescription for lactulose (Cephulac). The nurse teaches the client and the client's spouse how to administer this medication. Which of the following statements would indicate that the client has understood the information?
- A. I'll take it with Maalox.'
- B. I'll mix it with apple juice.'
- C. I'll take it with a laxative.'
- D. I'll mix the crushed tablets in some gelatin.'
Correct Answer: B
Rationale: Mixing lactulose with apple juice (B) improves palatability. Maalox (A) is unrelated, additional laxatives (C) are unnecessary, and lactulose is a liquid, not a tablet (D).
An adult client with type 2 diabetes is taking metformin (Glucophage) 1,000 mg two times every day. After the nurse provides instructions regarding the interaction of alcohol and metformin, the nurse evaluates that the client understands the instructions when the client says:
- A. If I know I'll be having alcohol, I must not take metformin; I could develop lactic acidosis.'
- B. If my physician approves, I may drink alcohol with my metformin.'
- C. Adverse effects I should watch for are feeling excessively energetic, unusual muscle stiffness, low back pain, and a rapid heartbeat.'
- D. If I feel bloated, I should call my physician.'
Correct Answer: A
Rationale: Alcohol combined with metformin increases the risk of lactic acidosis, a serious complication. The client should avoid alcohol while taking metformin.
A 17-year-old, sexually active female client is seen in the family planning clinic and requests hormonal contraceptives. Before examination, the nurse should explain the importance of regular Papanicolaou (Pap) smears. This recommendation is based on the current screening guidelines of the American Cancer Society for Pap smears, which state that:
- A. Pap smears are recommended every other year.
- B. If four consecutive annual Pap smears are negative, the client should schedule repeat Pap smears every 3 years.
- C. The initial Pap smear should be done at age 12.
Correct Answer: B
Rationale: American Cancer Society guidelines recommend Pap smears every 3 years after four consecutive normal annual smears for women who are sexually active or over 21. Screening does not start at age 12, and every-other-year screening is not standard.