Which of the following statements by the client indicates an understanding of the teaching?
- A. I should keep the medication in the original container.
- B. I should replace any unused medication every 6 months.
- C. I can store the medication in the refrigerator.
- D. I can crush the medication and mix with applesauce.
Correct Answer: A
Rationale: The correct answer is A because keeping medication in the original container ensures proper identification, dosage, and expiration monitoring. Choice B is incorrect as replacing unused medication every 6 months may lead to waste. Choice C is incorrect as not all medications should be stored in the refrigerator. Choice D is incorrect as crushing medication may alter its effectiveness or cause harm. It is important for the client to understand the importance of following specific storage instructions provided with the medication, making choice A the most appropriate response.
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Which of the following should the nurse identify as an expected finding?
- A. Weak femoral pulses
- B. Frequent nosebleeds
- C. Upper extremity hypotension
- D. Increased intracranial pressure
Correct Answer: A
Rationale: Coarctation of the aorta often results in weak or absent femoral pulses due to reduced blood flow to the lower extremities.
Which of the following manifestations should the nurse expect?
- A. Shortness of breath
- B. Dizziness
- C. Epistaxis
- D. Headache
Correct Answer: B
Rationale: Dizziness reflects reduced circulating volume.
For each potential nursing action, click to specify if the action is anticipated or contraindicated for the client.
- A. Perform suctioning
- B. Assess for urinary retention.
- C. Assess blood pressure every 15 min
- D. Withhold pain medication for headache until other manifestations resolve.
- E. Place client in supine position
- F. Administer nifedipine.
Correct Answer:
Rationale: Rationales provided within the question context.
Which of the following tasks should the charge nurse assign to a licensed practical nurse?
- A. Complete discharge teaching for a client who has a new diagnosis of diabetes mellitus.
- B. Complete the Glasgow Coma Scale for a client who has an evolving stroke.
- C. Perform a sterile dressing change for a client who has an abdominal wound.
- D. Perform an admission assessment for a client who is scheduled for surgery.
Correct Answer: C
Rationale: LPNs are trained for sterile dressing changes.
Which of the following actions should the nurse take?
- A. Assign the child to a negative air pressure room.
- B. Use droplet precautions when caring for the child
- C. Assess the child for Koplik spots
- D. Administer aspirin to the child for fever.
Correct Answer: A
Rationale: Negative pressure rooms prevent airborne spread of varicella.