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Which symptom suggests bladder cancer recurrence?
- A. Painful urination.
- B. Frequent urination.
- C. Hematuria.
- D. Nocturia.
Correct Answer: C
Rationale: Hematuria is a common sign of bladder cancer recurrence.
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The nurse is transfusing one unit of packed red blood cells (PRBCs) to a client. The nurse initiated the transfusion at 1400. After completing the 1545 vital signs, the nurse should take which action? See the image below.
- A. Stop the transfusion
- B. Verify the blood product with another nurse
- C. Apply nasal cannula oxygen
- D. Document the findings and continue the transfusion
Correct Answer: D
Rationale: Without specific abnormal vital signs provided in the image, the nurse should document the findings and continue the transfusion if vital signs are stable, as this is standard practice after monitoring. Stopping the transfusion, verifying the product again, or applying oxygen require specific indications of a transfusion reaction or instability.
A client has been admitted to the coronary care unit. The nurse observes third-degree heart block at a rate of 35 bpm on the client's cardiac monitor. The client has a blood pressure of 90/60. The nurse should take which of the following actions first?
- A. Prepare for transcutaneous pacing.
- B. Prepare to defibrillate the client at 200 joules.
- C. Administer atropine 0.5 mg I.V. push.
- D. Schedule the operating room for insertion of a permanent pacemaker.
Correct Answer: A
Rationale: Third-degree heart block with a rate of 35 bpm and hypotension requires immediate transcutaneous pacing to restore adequate heart rate and perfusion.
A client requests a narcotic analgesic shortly after the oncoming nurse receives change-of-shift report. The nurse who is leaving reported that the client had received morphine 10 mg (IM) within the past hour. The nurse should ask the outgoing RN to do which of the following actions?
- A. Validate with the outgoing RN that morphine 10 mg (IM) had been administered.
- B. Assess the client for manifestations of pain.
- C. Check the medication documentation as to when morphine 10 mg (IM) was dispensed and to whom.
- D. Check to ascertain if any discrepancy had been documented with accompanying reason/s.
Correct Answer: A
Rationale: Validating with the outgoing RN confirms the morphine administration, ensuring safe timing of the next dose and preventing overdose.
The American Heart Association (AHA) guidelines urge greater availability of automated external defibrillators (AEDs) and people trained to use them. AEDs are used in cardiac arrest situations for:
- A. Early defibrillation in cases of atrial fibrillation.
- B. Cardiovascular placement.
- C. Early defibrillation in cases of ventricular fibrillation.
- D. None of the above
Correct Answer: C
Rationale: AEDs are used for early defibrillation in ventricular fibrillation or pulseless ventricular tachycardia, as these are shockable rhythms that can be corrected to restore cardiac function.
A client with rib fractures and a pneumothorax has a chest tube inserted that is connected to a water-seal chest tube drainage system. The nurse notes that the fluid in the water-seal column is fluctuating with each breath that the client takes. What is the significance of this fluctuation?
- A. An obstruction is present in the chest tube.
- B. The client is developing subcutaneous emphysema.
- C. The chest tube system is functioning properly.
- D. There is a leak in the chest tube system.
Correct Answer: C
Rationale: Fluctuation in the water-seal column with breathing indicates a patent chest tube system, reflecting pleural pressure changes. Obstruction, emphysema, or leaks would show different signs.