Which of the following is an essential component for insuring that medical equipment is being used safely and properly by those who you supervise?
- A. Education and training on all pieces of equipment
- B. Pilot testing new equipment
- C. Reading all the manufacturer's instructions
- D. Researching the equipment before recommending its purchase
Correct Answer: A
Rationale: Education and training on all pieces of equipment is essential to ensure staff can use equipment safely and correctly, reducing risks to clients and staff.
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A client diagnosed with valvular heart disease is at risk for developing heart failure. What should the nurse assess as the priority when monitoring for heart failure?
- A. Heart rate
- B. Breath sounds
- C. Blood pressure
- D. Activity tolerance
Correct Answer: B
Rationale: Breath sounds are the best way to assess for the onset of heart failure. The presence of crackles or an increase in crackles is an indicator of fluid in the lungs caused by heart failure. The remaining options are components of the assessment but are less reliable indicators of heart failure.
A client with a history of schizophrenia is prescribed quetiapine (Seroquel). The nurse should monitor the client for which of the following adverse effects?
- A. Weight gain.
- B. Hypoglycemia.
- C. Bradycardia.
- D. Hypotension.
Correct Answer: A, D
Rationale: Quetiapine can cause weight gain and hypotension.
As you are assessing the fetus during labor you are determining and the fetal lie, presentation, attitude, station and position. Your client asks you what all these assessments are. Among other things, how should you respond to the mother?
- A. You should explain that fetal lie is where the fetus' presenting part is within the birth canal during labor, among other information about the other assessments.
- B. You should explain that fetal presentation is the relationship of the fetus's spine to the mother's spine, among other information about the other assessments.
- C. You should explain that fetal attitude is the relationship of the fetus' presenting part to the anterior, posterior, right or left side of the mother's pelvis, among other information about the other assessments.
- D. You should explain that fetal station is the level of the fetus' presenting part in relationship to the mother's ischial spines, among other information about the other assessments.
Correct Answer: D
Rationale: Fetal station refers to the level of the fetus's presenting part relative to the mother's ischial spines, measured in centimeters above or below the spines. This is the correct definition among the options provided.
The nurse is caring for a client post-total knee replacement. Which sign indicates a potential deep vein thrombosis?
- A. Calf swelling and pain
- B. Fever of 100°F (37.8°C)
- C. Mild incisional redness
- D. Joint stiffness
Correct Answer: A
Rationale: Calf swelling and pain are classic signs of deep vein thrombosis, a common postoperative complication requiring immediate evaluation.
A client is a 43-year-old G2 P1 at 16 weeks' gestation that has completed prenatal testing for chromosomal abnormalities. The results reveal the infant is a female with Down syndrome. The nurse should tell the parents which of the following? Check all that apply.
- A. Down syndrome can occur in mothers of any age.
- B. Down syndrome is correlated with autosomal dominant traits carried by the parents.
- C. Down syndrome is a result of autosomal recessive traits carried by the parents.
- D. Down syndrome depends upon maternal prenatal care since pregnancy began.
- E. Down syndrome occurs more frequently with advanced maternal age.
- F. Down syndrome results from a trisomy of chromosome 21.
Correct Answer: A,E,F
Rationale: Down syndrome can occur at any maternal age, is more frequent with advanced maternal age, and results from trisomy 21. It is not related to dominant/recessive traits or prenatal care.
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