Nokea
Which type of legal consent is indirectly given by the client by the very nature of their voluntary acute care hospitalization?
- A. An opt out consent
- B. An implicit consent
- C. An explicit consent
- D. No consent at all is given
Correct Answer: B
Rationale: Implicit consent is given by the client's voluntary admission to an acute care facility, implying agreement to routine treatments and procedures necessary for their care, unless explicitly refused.
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A client with a history of cirrhosis is prescribed propranolol (Inderal). The nurse should monitor the client for which of the following therapeutic effects?
- A. Decreased portal hypertension.
- B. Increased blood glucose.
- C. Decreased ammonia levels.
- D. Increased platelet count.
Correct Answer: A
Rationale: Propranolol reduces portal hypertension by decreasing portal vein pressure in cirrhosis.
A client being discharged from the hospital with a diagnosis of gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. The nurse determines that the client understands proper use of the medication when the client states the intention to take the medication at which time?
- A. With meals and at bedtime
- B. Every 6 hours around the clock
- C. One hour after meals and at bedtime
- D. One hour before meals and at bedtime
Correct Answer: D
Rationale: Sucralfate is an antiulcer medication. The medication should be scheduled for administration 1 hour before meals and at bedtime. This timing will allow the medication to form a protective coating over the ulcer before it becomes irritated by food intake, gastric acid production, and mechanical movement. The other options are incorrect.
Which of the following should be a priority nursing diagnosis for a client who has had a total laryngectomy?
- A. Risk for impaired skin integrity.
- B. Excess fluid volume.
- C. Ineffective thermoregulation.
- D. Impaired verbal communication.
Correct Answer: D
Rationale: Impaired verbal communication is the priority after a total laryngectomy due to the loss of vocal cords, affecting communication ability.
Which couple is at greatest risk for domestic violence?
- A. A couple which consists of a husband and wife both of whom are affected with Alzheimer's disease
- B. A poverty stricken couple without any healthcare resources in the community
- C. A pregnant woman and a husband who was physically abused as a young child
- D. A wealthy couple with feelings that they are immune from punishment and above the law
Correct Answer: C
Rationale: A history of childhood physical abuse is a significant risk factor for perpetrating domestic violence, as it may lead to learned behaviors or unresolved trauma. Pregnancy can also increase stress and vulnerability, further elevating the risk.
The nurse is caring for a client who has just had a mastectomy. Which exercise should the nurse assist the client in doing during the first 24 hours after surgery?
- A. Hand wall climbing
- B. Pendulum arm swings
- C. Elbow flexion and extension
- D. Shoulder abduction and external rotation
Correct Answer: C
Rationale: During the first 24 hours after surgery, the client is assisted to move the fingers and hands, and to flex and extend the elbow. The client may also use the arm for self-care provided that she does not raise the arm above shoulder level or abduct the shoulder. The exercises identified in the remaining options are done once surgical drains are removed and wound healing is well established.