Nokea
Which of these statements from clients who call the community health clinic would suggest the need for a same-day appointment to be seen by the health care provider?
- A. I started my period and now my urine has turned bright red'
- B. I am a diabetic and today I have been going to the bathroom every hour'
- C. I was started on medicine yesterday for a urine infection. Now my lower belly hurts when I go to the bathroom'
- D. I went to the bathroom and my urine looked very red and it didn't hurt when I went'
Correct Answer: D
Rationale: With this description of symptoms this client needs to be seen that day since painless gross hematuria is closely associated with bladder cancer. The other complaints can be handled over the phone.
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An 86 year-old nursing home resident who has impaired mental status is hospitalized with pneumonic infiltrates in the right lower lobe. When the nurse assists the client with a clear liquid diet, the client begins to cough. What should the nurse do next?
- A. Add a thickening agent to the fluids
- B. Check the client's gag reflex
- C. Feed the client only solid foods
- D. Increase the rate of intravenous fluids
Correct Answer: B
Rationale: Check the client's gag reflex. When a new problem emerges, the nurse should perform appropriate assessment so that suitable nursing interventions can be planned. Aspiration pneumonia follows aspiration of material from the mouth into the trachea and finally the lung. A loss or an impairment of the protective cough reflex can result in aspiration.
A college student is hospitalized with meningococcal meningitis after being seen in the campus clinic. What is the nurse's responsibility to the campus community regarding this diagnosis?
- A. Quarantine all students and faculty remaining on the campus
- B. E-mail school administrators with the names of infected students
- C. Identify all individuals who have had close contact with the student
- D. Ensure that everyone on campus receive prophylactic antibiotics
Correct Answer: C
Rationale: C: Identifying close contacts allows targeted prophylaxis, preventing spread. A: Quarantine is excessive. B: Sharing names violates privacy. D: Prophylaxis is only for close contacts.
The nurse is to administer cefazolin sodium 1 g in 100 mL 0.9% NaCl over 30 minutes. At what rate in mL/hour should the nurse plan to set the infusion pump?
Correct Answer: 200
Rationale: 100 mL/ 0.5 hours = 200 mL/hour.
The nurse is preparing to care for the client with Ebola, a febrile, hemorrhagic disease. After selecting a disposable surgical hood that extends to the shoulders, what additional PPE should the nurse obtain? Select all that apply.
- A. Docimeter
- B. Disposable N95 respirator
- C. Disposable full face shield
- D. Cloth gown that cannot be reused
- E. Two pair nitrile examination gloves
- F. Boot covers extending to mid-calf
Correct Answer: B,C,E,F
Rationale: B: N95 respirator protects against possible airborne transmission. C: Face shield prevents mucosal exposure. E: Double gloves enhance protection. F: Boot covers prevent lower leg exposure. A: Docimeters are for radiation. D: Cloth gowns are inadequate; impermeable gowns are needed.
A client diagnosed with cirrhosis of the liver and ascites is receiving spironolactone (Aldactone). The nurse understands that this medication spares elimination of which element?
- A. Sodium
- B. Potassium
- C. Phosphate
- D. Albumin
Correct Answer: B
Rationale: Potassium. If ascites is present in the client with cirrhosis of the liver, potassium-sparing diuretics such as Aldactone should be administered because it inhibits the action of aldosterone on the kidneys.