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NEW QUESTION # 366
During the assessment, the nurse observes a client scratching his skin. He has been admitted to rule out Laennec's cirrhosis of the liver. The nurse knows the pruritus is directly related to:
- A. Enhanced detoxification of drugs
- B. Faulty processing of bilirubin
- C. The formation of collateral circulation
- D. A loss of phagocytic activity
Answer: B
Explanation:
Explanation
(A) A loss in the phagocytic activity of the Kupffer cells occurs with cirrhosis of the liver, which increases the susceptibility to infections. (B) The faulty processing of bilirubin produces bilesalts, which are irritating to the skin. (C) The detoxification of drugs is impaired with cirrhosis of the liver. (D) Collateral circulation develops due to portal hypertension. This is manifest through the development of esophageal varices, hemorrhoids, and caput medusae.
NEW QUESTION # 367
A mother brings a 6-month-old infant and a 4-year-old child to the nursing clinic for routine examination and screening. Which of these plans by the nurse would be most successful?
- A. Have the mother leave the room with one child, and examine the other child privately.
- B. Examine painful areas first to get them "over with."
- C. Examine the 4 year old first.
- D. Provide time for play and becoming acquainted.
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) The 6 month old should be examined first. If several children will be examined, begin with the most cooperative and less anxious child to provide modeling. (B) Providing time for play and getting acquainted minimizes stress and anxiety associated with assessment of body parts. (C) Children generally cooperate best when their mother remains with them. (D) Painful areas are best examined last and will permit maximum accuracy of assessment.
NEW QUESTION # 368
At her monthly prenatal visit, a client reports experiencing heartburn. Which nursing measure should be included in her plan of care to help alleviate it?
- A. Lie down after eating.
- B. Use Alka-Seltzer as necessary.
- C. Eat small, frequent bland meals.
- D. Restrict fluid intake.
Answer: C
Explanation:
(A) At least eight glasses of fluid per day are encouraged to help dilute stomach contents, thereby decreasing irritation. (B) Alka Seltzer contains aspirin, which is irritating to gastric mucosa, and therefore should be avoided. (C) Small, frequent bland meals help to decrease gastric pressure and to prevent reflux. (D) Lying down after meals may cause gastric reflux and prevents optimal gastric emptying.
NEW QUESTION # 369
Which behavior by a female client feeding her newborn demonstrates that she needs more teaching related to safety and infant feeding?
- A. She uses the bulb syringe to help clear her baby's nose when milk is regurgitated.
- B. She places her infant on her right side after feeding her.
- C. She burps her baby by placing her in a sitting position, supporting her head and neck and gently massaging her back.
- D. She props the bottle in the crib to feed her baby,which allows her to write birth announcements and feed her baby at the same time.
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) This practice is the proper use of the bulb syringe to clear the infant's airway in case of regurgitation.
(B) Placing the infant on either side or on the stomach prevents aspiration of regurgitated milk. (C) "Bottle propping" is an unsafe practice because it increases the likelihood of aspiration. (D) This practice is one correct way of burping an infant.
NEW QUESTION # 370
The doctor has ordered a restricted fluid intake for a 2- year-old child with a head injury. Normal fluid intake for a child of 2 years is:
- A. 2000 mL/24 hr
- B. 1600 mL/24 hr
- C. 1300 mL/24 hr
- D. 900 mL/24 hr
Answer: B
Explanation:
Explanation
(A, B, D) These values are incorrect. Normal intake for a child of 2 years is about 1600 mL in 24 hours. (C) This value is correct. Normal intake for a child of 2 years is about 1600 mL in 24 hours.
NEW QUESTION # 371
A 33-year-old client is diagnosed with bipolar disorder, acute phase. This is her first psychiatric hospitalization, and she is being evaluated for treatment with lithium. Which of the following diagnostic tests are essential prior to the initiation of lithium therapy with this client?
- A. Glucose, glucose tolerance test, and random blood sugar
- B. Blood urea nitrogen, electrolytes, and creatinine
- C. X-rays, electroencephalogram, and electrocardiogram(ECG)
- D. Hematocrit, hemoglobin, and white blood cell (WBC) count
Answer: B
Explanation:
Section: Questions Set G
Explanation:
(A) These are general diagnostic blood studies (usually done on admission), but they are not reliable indicators of lithium therapy clearance. (B) These are the primary diagnostic tests to determine kidney functioning.
Because lithium is excreted through the kidneys and because it can be very toxic, adequate renal function must be ascertained before therapy begins. (C) These are diagnostic blood tests used to determine the presence of endocrine (not renal) dysfunction. (D) These are other types of diagnostic procedures used to determine musculoskeletal, neural, and cardiac (rather than renal) functioning.
NEW QUESTION # 372
A client is placed on lithium therapy for her manic-depressive illness. When monitoring the client, the nurse assesses the laboratory blood values. Toxicity may occur with lithium therapy when the blood level is above:
- A. 1.5 mEq/L
- B. 1.0 mEq/L
- C. 2.2 mEq/L
- D. 0.03 mEq/L
Answer: A
Explanation:
Section: Questions Set D
Explanation:
(A) This value is a low blood level. (B) This value is a toxic blood level. (C) This value is a low blood level. (D) This value is the level at which most clients are maintained, and toxicity may occur if the level increases. The client should be monitored closely for symptoms, because some clients become toxic even at this level.
NEW QUESTION # 373
A client was admitted to the hospital for a TURP. Within 48 hours of admission and 12 hours postoperatively, both the blood pressure and pulse increased. He became agitated, thought snakes were crawling on his arms and legs, and generally became unmanageable. He pulled out his IV and urinary catheter in attempt to rid himself of the snakes. He was sweating profusely. The admission nurse's notes indicated that the client admitted to "having a few drinks now and then." He is probably experiencing which of the following?
- A. Generalized anxiety disorder
- B. Major psychotic depression
- C. Adjustment disorder with mixed features
- D. Delirium tremens
Answer: D
Explanation:
(A) Symptoms of psychotic depression must exist for at least 2 weeks, and the symptoms must represent a change from previous functioning. (B) Delirium tremens occur approximately on the second or third day following cessation or reduction of alcohol intake. Symptoms would be all those described in the situation. (C) Symptoms exhibited by this client are not exhibited in clients with anxiety disorders, who manifest excessive or unrealistic worry about life circumstances for at least 6 months. (D) Symptoms for adjustment disorders with mixed emotional features (e.g., depression and anxiety) are different from those exhibited by the client in this situation.
NEW QUESTION # 374
A 55-year-old man is admitted to the hospital with complaints of fatigue, jaundice, anorexia, and clay-colored stools. His admitting diagnosis is "rule out hepatitis." Laboratory studies reveal elevated liver enzymes and bilirubin. In obtaining his health history, the nurse should assess his potential for exposure to hepatitis.
Which of the following represents a high-risk group for contracting this disease?
- A. Jehovah's Witnesses
- B. Oncology nurses
- C. Heterosexual males
- D. American Indians
Answer: B
Explanation:
Explanation
(A) Homosexual males, not heterosexual males, are at high risk for contracting hepatitis. (B) Oncology nurses are employed in high-risk areas and perform invasive procedures that expose them to potential sources of infection. (C) The literature does not support the idea that any ethnic groups are at higher risk. (D) There is no evidence that any religious groups are at higher risk.
NEW QUESTION # 375
A male client has experienced low back pain for several years. He is the primary support of his wife and six children. Although he would qualify for disability, he plans to continue his employment as long as possible.
His back pain has increased recently, and he is unable to control it with non-steroidal anti-inflammatory agents. He refuses surgery and cannot take narcotics and remain alert enough to concentrate at work. His physician has suggested application of a transcutaneous electrical nerve stimulation (TENS) unit. Which of the following is an appropriate rationale for using a TENS unit for relief of pain?
- A. TENS units work on the gate-control theory of pain; biostimulation therapy of large fibers block painful stimuli.
- B. TENS units produce endogenous opioids that affect the central nervous system with analgesic potency comparable to morphine.
- C. TENS units have an ultrasonic effect that relaxes muscles, decreases joint stiffness, and increases range of motion.
- D. TENS units prevent muscle spasms, decrease the potential for further injury, and minimize pressure on joints.
Answer: A
Explanation:
Explanation
(A) TENS units do not have this effect, but whirlpool therapy does. (B) TENS units do not produce endogenous opioids, only the body can do that. (C) TENS units do work based on the gatecontrol theory of pain control. (D) TENS units do not have this effect, but possibly changing the client's position would.
NEW QUESTION # 376
A client is to be discharged from the hospital and is to continue taking warfarin 2.5 mg po bid. Which of the following should be included in her discharge teaching concerning the warfarin therapy?
- A. "You should take aspirin instead of acetaminophen (Tylenol) for headaches."
- B. "You should use a straight-edge razor when shaving your arms and legs."
- C. "Carry a medications alert card with you at all times."
- D. "If you forget to take your morning dose, double the night time dose."
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Warfarin must always be taken exactly as directed. Clients should be instructed never to skip or double up on their dosage. (B) Aspirin decreases platelet aggregation, which would potentiate the effects of the coumadin. (C) Healthcare providers need to be aware of persons on warfarin therapy prior to the initiation of any diagnostic tests and/or surgery to help prevent bleeding complications. (D) An electric razor should be used to prevent accidental cutting, which can lead to bleeding.
NEW QUESTION # 377
A nurse should carefully monitor a client for the following side effect of MgSO4:
- A. Respiratory depression
- B. Tachypnea
- C. Visual blurring
- D. Epigastric pain
Answer: A
Explanation:
Explanation
(A, C) The nurse should provide good distractors because these symptoms indicate that PIH has become more severe and may precede the convulsive or eclamptic phase. (B) This is the oppositeside effect of this medication. (D) This is a common side effect of this medication and needs to be monitored and recorded frequently.
NEW QUESTION # 378
When assessing a child with diabetes insipidus, the nurse should be aware of the cardinal signs of:
- A. Irritability relieved by feeding formula
- B. Hypothermia and azotemia
- C. Anemia and vomiting
- D. Polyuria and polydipsia
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Anemia and vomiting are not cardinal signs of diabetes insipidus. (B) Polyuria and polydipsia are the cardinal signs of diabetes insipidus. (C) Irritability relieved by feeding water, not formula, is a common sign, but not the cardinal sign, of diabetes insipidus. (D) Hypothermia and azotemia are signs, but not cardinal signs, of diabetes insipidus.
NEW QUESTION # 379
The healthcare team determines that an elderly client has had progressive changes in memory over the last 2 years that have interfered with her personal, social, or occupational functioning. Her memory, learning, attention, and judgment have all been affected in some way. These symptoms describe which of the following conditions?
- A. Dementia
- B. Parkinsonism
- C. Mania
- D. Delirium
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) These changes are common characteristics of dementia. (B) Parkinson's disease affects the muscular system. Progressive memory changes are not presenting symptoms. (C) Delirium includes an altered level of consciousness, which is not found in dementia. (D) Mania includes symptoms of hyperactivity, flight of ideas, and delusions of grandeur.
NEW QUESTION # 380
What specific hormone must be present in serum or urine laboratory tests used to diagnose pregnancy?
- A. α-fetoprotein
- B. Estrogen
- C. Sphingomyelin
- D. Human chorionic gonadotropin
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Human chorionic gonadotropin is the biochemical basis for pregnancy tests. It is produced by the placenta to help maintain the corpus luteum. Its levels climb rapidly following conception, peaking at about
8 weeks and then gradually decreasing to low levels after 16 weeks. (B) Estrogen does steadily rise throughout pregnancy, increasing to 30 times that of prepregnancy levels. Although estrogen levels do change during pregnancy, it is not used as the main hormone of evaluation in pregnancy tests. (C) α- Fetoprotein is the major protein in the serum of theembryo. It is initially produced by the yolk sac. (D) Lecithin and sphingomyelin are two phospholipids of which fetal lung surfactant is composed. Levels are evaluated to determine fetal lung maturity.
NEW QUESTION # 381
The nurse is admitting an infant with bacterial meningitis and is prepared to manage the following possible effects of meningitis:
- A. Seizure
- B. Sunken fontanelles
- C. Hypothermia
- D. Constipation
Answer: A
Explanation:
(A) Constipation may occur if the child is dehydrated, but it is not directly associated with meningitis. (B) It is more likely the child will have fever. (C) Seizure is often the initial sign of meningitis in children and could become frequent. (D) It is more likely the child will have bulging fontanelles.
NEW QUESTION # 382
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