Which oxygen delivery system would the nurse apply that would provide the highest concentrations of oxygen to the client?
- A. Venturi mask
- B. Partial rebreather mask
- C. Non-rebreather mask
- D. Simple face mask
Correct Answer: C
Rationale: Non-rebreather mask. The non-rebreather mask has a one-way valve that prevents exhaled air from entering the reservoir bag and one or more valves covering the air holes on the face mask itself to prevent inhalation of room air but to allow exhalation of air. When a tight seal is achieved around the mask up to 100% of the oxygen is available.
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A client with cancer tells the nurse that he would like to make out a living will. The nurse knows that a living will provides documentation of:
- A. The client's desire to receive all means of assistance to sustain life.
- B. The client's desire to allow another to make decisions regarding his care.
- C. The client's wish to die without life-prolonging interventions.
- D. The client's desire to have his life terminated by active euthanasia.
Correct Answer: C
Rationale: A living will documents a client's wish to avoid life-prolonging interventions in terminal conditions. It does not mandate all assistance, delegate decisions, or support euthanasia.
The health care provider prescribes phenazopyridine hydrochloride for a client with a urinary tract infection. What would the office nurse remind the client to expect while taking this medication?
- A. Constipation
- B. Difficulty sleeping
- C. Discoloration of urine
- D. Dry mouth
Correct Answer: C
Rationale: Phenazopyridine causes orange-red urine discoloration, a benign effect. Constipation , insomnia , and dry mouth are not typical.
The nurse is preparing to obtain a urine specimen for urinalysis from an 18-month-old client. Which of the following actions should the nurse take?
- A. Perform intermittent straight catheterization to obtain the urine from the client.
- B. Apply an adhesive urine collection bag around the client's genital area.
- C. Ask the parent to obtain the client's urine using a specimen cup
- D. Place a urine dipstick in the client's diaper overnight.
Correct Answer: B
Rationale: An adhesive collection bag is non-invasive and effective for toddlers. Catheterization is invasive, a cup is impractical, and a dipstick is inaccurate.
The clinic nurse is reinforcing teaching to a client about levothyroxine, which the health care provider has prescribed for newly diagnosed hypothyroidism. Which statement made by the client indicates that further teaching is needed?
- A. I will need to get my blood drawn to see if I'm taking the right dose.
- B. I will probably need to take this the rest of my life.
- C. I will take this once a day in the morning.
- D. If this makes my stomach upset, I will take it with an antacid.
Correct Answer: D
Rationale: Antacids reduce levothyroxine absorption, requiring further teaching. Blood monitoring , lifelong use , and morning dosing are correct.
At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about preconception diet changes. Which of the statements made by the nurse is best?
- A. Include fibers in your daily diet.
- B. Increase green leafy vegetable intake.
- C. Drink milk for the calcium content.
- D. Eat foods rich in folic acid.
Correct Answer: D
Rationale: Eat foods rich in folic acid. Folic acid is essential for preventing neural tube defects in the developing fetus, making it a critical preconception dietary recommendation.
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