• A client who had an intraosseous (IO) cannula placed by the healthcare providerfor an emergent fluid resuscitation is complaining of severe pain and
... [Show More] numbness below the IO site. The skin around the site is pale and edematous. What action should the nurse takes first?
a. Discontinue the IO infusion
b. Administer an analgesic via the IO site
c. Elevate the extremity with the IO site
d. Notify the healthcare provider Correct A
• The nurse-manager of a perinatal unit is notified that one client from the medical-surgical unit needs to be transferred to male room for new admissions. Which client should the nurse recommend for transfer to the antepartal unit?
a. A 45-year-old who has a chronic hepatitis B.
b. A 35-year-old with lupus erythematous
c. A 19-year-old who is diagnosed with rubella
d. A 25-year-old with herpes lesions of the vulva Correct B
• A nurse is teaching a client postoperative breathing techniques using an incentive spirometer (IS). What should the nurse encourage this client to doto maintain sustained maximal inspiration?
a. Breathe into the spirometer using normal breath volumes
b. Exhale forcefully into the tubing for 3 to 5 seconds
c. Inspire deeply and slowly over 3 to 5 seconds
d. Perform IS breathing exercises every 6 hours
Correct C
• The nurse plans to educate a client about the purpose for taking the prescribed antipsychotic medication clozapine (Clozaril). Which statementshould the nurse provide?
a. You will be able to cope with your symptoms
b. It will help you function better in the community
c. The medication will help you think more clearly”
d. It will improve your grooming and hygiene Correct C
• A 59-year-old male client is brought to the emergency room where he is assessed to have a Glasgow Coma Scale of 3. Based on this assessment, how should the nurse characterizes the client’s condition?
a. The client has increased intracranial pressure
b. He has a good prognosis for recovery
c. This client is conscious, but is not oriented to time and place
d. He is in a coma, and has a very poor prognosis Correct D
• At a community health fair, a 50-year-old woman tells the nurse that she has an annual physical exam that includes a clinical breast exam and an annual mammogram. How should the nurse respond?
a. Encourage the woman to explore her fears about breast cancer. b. Ask the woman if she also performs monthly breast self- exams.
c. Commend the woman for adhering to the recommended cancer detection guidelines.
d. Advise the woman that mammograms are only needed every two years ather age.
Correct B [Show Less]