requests information about acupuncture to relieve some of the side
effects. Which of the following findings should the nurse identify as
a contraindication to receiving this alternative therapy?
A. Urticaria
B. Lymphedema
C. Headaches
D. Mouth sores
Lymphedema
A nurse is preparing to administer lactated Ringer's via continuos IV
infusion at 200 ml/hr. The IV tubing has a drop factor of 10 drops/mL.
How many gtt/min should the nurse set the IV ump to administer?
33
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A nurse is providing discharge teaching to a client who has a new
prescription for sublingual nitroglycerin. Which of the following
client statements indicates an understanding of the teaching?
a. "I should lie down when I take this medication."
b. "I can keep my medication for 1 year before replacing it."
c. "I should discontinue this medication if I develop a headache."
d. "I can take up to five tablets in 15 minutes before seeking
medical attention."
I should lie down when I take this medication
A nurse is providing discharge teaching to an older adult client
following total hip arthroplasty. Which of the following instructions
should the nurse include in the teaching?
a. "You can cross your legs at the ankles when sitting down."
b. "Clean the incision daily with hydrogen peroxide."
c. "Install a raised toilet seat in your bathroom."
d. "You should use an incentive spirometer every 8 hrs."
Install a raised toilet seat in your bathroom
,A nurse is planning care for a client following cardiac
catheterization. Which of the following actions should the nurse take?
a. Limit the client's fluid intake to 1 L per day.
b. Change the client's dressing every 8 hr.
c. Keep the client on bed rest for 24 hr.
d. Maintain he client's affected extremity in extension.
Maintain the client's affected extremity in extension
A nurse is caring for a client who has a lower extremity fracture and
a prescription for crutches. Which of the following client statements
indicates that the client is adapting to their role change?
a) I will need to have my partner take over shopping for groceries
and cooking the meals for us
b) it's going to be difficult to tell my parents I can't take them to
their appointments anymore
c) I feel bad that I have to ask my partner to keep the house clean d)
these crutches will make it impossible to care for my child
I will need to have my partner take over shopping for groceries and
cooking the meals for us
A nurse is providing teaching to a client who has an impaired immune
system due to chemotherapy. Which of the following information should
the nurse include in the teaching?
a. wash your toothbrush in the dishwasher once each month
b. Wash your perineal area two times each day with antimicrobial soap
c. Change your pet's litter box daily
d. change the water in your drinking glass every 4 hours
Wash your perineal area two times each day with anti microbial soap
A nurse is caring for a client who has a contusion of the brainstem
and reports thirst. The client's urinary output was 4,000 mL over the
past 24 hr. The nurse should anticipate a prescription for which of
the following IV medications?
a. Nitroprusside
b. Epinephrine
c. Furosemide
d. Desmopressin
Desmopressin
A nurse in a clinic receives a phone call from a client who recently
started therapy with an ACE inhibitor and reports a nagging dry cough.
Which of the following responses by the nurse is appropriate?
a. "Sucking on a lozenge may reduce the frequency of your cough."
, b. "Increasing your daily fluid intake may eliminate your cough."
c. "Your cough may require that you stop or change your medication."
d. "Your cough should go away in time."
C. "your cough may require that you stop or change your medication"
A nurse is taking an admission history from a client who reports
Raynaud's disease. Which of the following assessment findings should
the nurse identify as a potential trigger for exacerbations of
Raynaud's?
a. Eating a strict vegetarian diet
b. Taking amlodipine for hypertension
c. Using a nicotine transdermal patch
d. A history of herpes zoster
Using nicotine transdermal patch
A nurse is caring for a client who has a central venous access device
and notes the tubing has become disconnected. The client develops
dyspnea and tachycardia. Which of the following actions should the
nurse take first?
a. Clamp the catheter.
b. Turn the client to his left side.
d. Obtain ABG values
Turn the client to his left side
A nurse is completing an assessment of an older adult client and
notes reddened areas over the bony prominences, but the client's skin
is intact. Which of the following interventions should the nurse
include in the plan of care?
a. Support bony prominences with pillows.
b. Turn and reposition the client every 4 hr.
c. Massage the reddened areas three times daily.
d. Apply an occlusive dressing.
Support bony prominences with pillows
A home health nurse is making an initial visit to a client who has
multiple sclerosis. Which of the following actions is the priority
for the nurse to take?
a. Discuss recommendations for eating and swallowing techniques.
b. List strategies for family coping when dealing with possible role
changes.
c. Give the client information about the local National Multiple
Sclerosis Society.
d. Review the use of adaptive grooming devices to promote client
independence.