Prior to administering digoxin to a client with congestive heart failure, the nurse needs to assess:
A. Respiratory rate for 1 minute
B. Radial pulse for 1 minute
C. Radial pulse for 2 minutes
D. Apical pulse for 1 minute
A client has a history of alcoholism. He is currently diagnosed with cirrhosis of the liver. The nurse would expect him to be on which type of diet?
A. High protein and high calorie
B. High calorie and high carbohydrate
C. Low-fat 2-g sodium diet
D. High protein and high fat
A 23-year-old college student seeks medical attention at the college infirmary for complaints of severe fatigue. Her skin is pale, and she reports exertional dyspnea. She is admitted to the hospital with possible aplastic anemia. Laboratory values reflect anemia, and the client is prepared for a bone marrow biopsy. She refuses to sign the biopsy consent and states, "Can't you just get the doctor to give me a transfusion and let me go. This weekend begins spring break, and I have plans to go to Florida." At this time the nurse's greatest concern is that:
A. The client may contract an infection as a result of being exposed to large crowds at spring break
B. The client does not grasp the full impact of her illness
C. The client may require transfusion before leaving for spring break
D. The causative agent be identified and treatment begun
During an examination, the nurse notes that an infant has diaper rash on the convex surfaces of his buttocks, inner thighs, and scrotum. Which of the following nursing interventions will be most effective in resolving the condition?
A. Coating the inflamed areas with zinc oxide
B. Using talcum powder on the inflamed areas to promote drying
C. Removing the diaper entirely for extended periods of time
D. Cleaning the inflamed area thoroughly with disposable wet "wipes" at each diaper change
A 30-year-old client is exhibiting auditory hallucinations. In working with this client, the nurse would be most effective if the nurse:
A. Encourages the client to discuss the voices
B. Attempts to direct the client's attention to the here and now
C. Exhibits sincere interest in the delusional voices
D. Gives the medication as necessary for the acting-out behavior
A 67-year-old man had a physical examination prior to beginning volunteer work at the hospital. A routine chest x-ray demonstrated left ventricular hypertrophy. His blood pressure was 180/110. He is 45 lb overweight. His diet is high in sodium and fat. He has a strong family history of hypertension. The client is placed on antihypertensive medication; a low-sodium, low-fat diet; and an exercise regimen. On his next visit, compliance would best be determined by:
A. A blood pressure reading of 130/70 with a 5-lb weight loss
B. No side effects from antihypertensive medication and an accurate pill count
C. No evidence of increased left ventricular hypertrophy on chest x-ray
D. Serum blood levels of the antihypertensive medication within therapeutic range
A client has begun to exhibit signs of alcohol withdrawal. Her blood pressure has risen from 120/60 to 190/100, pulse is increased from 88 to 110 bpm, and she is irritable and agitated and has gross motor tremors of the hands. The nurse notifies the doctor. The nurse can anticipate that the doctor will order which of the following?
A. An opiate such as propoxyphene napsylate (Darvocet)
B. A benzodiazepine such as chlordiazepoxide (Librium)
C. A tricyclic antidepressant such as amitriptyline (Elavil)
D. A phenothiazine such as chlorpromazine (Thorazine)
A 43-year-old client is admitted to the hospital with a diagnosis of peripheral vascular disorder. She arrives in her room via stretcher and requires assistance to move to her bed. The nurse notes that her left leg is cold to touch. She complains of having recently experienced muscle spasms in that leg. To determine if these muscle spasms are indicative of intermittent claudication, the nurse would begin her assessment with the following question:
A. "Would you describe the intensity, duration, and symptoms associated with your pain?"
B. "Do you experience swelling at the end of the day in the affected and unaffected leg?"
C. "Have you had any lesions of the affected leg that have been difficult to heal?"
D. "Do your muscle spasms occur following rest, walking, or exercising?"
A 75-year-old client is hospitalized with pneumonia caused by gram-positive bacteria. Which one of the following best describes a gram-positive bacterial pneumonia?
A. Klebsiellapneumonia
B. Pneumococcal pneumonia
C. Legionella pneumophilapneumonia
D. Escherichia colipneumonia
A client's transfusion of packed red blood cells has been infusing for 2 hours. She is complaining of a raised, itchy rash and shortness of breath. She is wheezing, anxious, and very restless. The nurse knows these assessment findings are congruent with:
A. Hemolytic transfusion reaction
B. Febrile transfusion reaction
C. Circulatory overload
D. Allergic transfusion reaction
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