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NEW QUESTION # 245
When assessing a female child for Turner's syndrome, the nurse observes for which of the following symptoms?
- A. Gynecomastia
- B. Tall stature
- C. Amenorrhea
- D. Secondary sex characteristics
Answer: C
Explanation:
Explanation
(A) This syndrome is caused by absence of one of the X chromosomes. These children are short in stature. (B) Amenorrhea is a symptom of Turner's syndrome, which appears at puberty. (C) Sexual infantilism is characteristic of this syndrome. (D) Gynecomastia is a symptom in Klinefelter's syndrome.
NEW QUESTION # 246
A client has been instructed in how to take her nitroglycerin tablets. The nurse giving her instructions knows the client understands the information when she tells her:
- A. "I should call the doctor if three doses of the medicine do not relieve my pain."
- B. "I should take these with water but not with milk."
- C. "I should contact my physician if I have headaches after I take this medicine."
- D. "I should keep the tablets in the refrigerator."
Answer: A
Explanation:
(A) Headaches may occur after taking nitroglycerin because of vasodilation. (B) The tablets do not need to be refrigerated. The client should carry them with her. (C) The client should contact the physician if repeated doses of nitroglycerin do not relieve the discomfort. (D) Nitroglycerin tablets should be dissolved under the tongue, not swallowed.
NEW QUESTION # 247
A male client has heart failure. He has been instructed to gradually increase his activities. Which signs and symptoms of worsening heart failure should the nurse tell him to watch for that would indicate a need for him to lower his activity level?
- A. Thirst, weight loss, and polyuria
- B. Pain in his legs when he walks
- C. Weight gain, edema in his lower extremities, and shortness of breath
- D. Drowsiness and lethargy after his activities
Answer: C
Explanation:
(A) Pain in the legs could be indicative of doing too much too quickly, but not of worsening heart failure. The client should be cautioned to increase his activities slowly. (B) Thirst, weight loss, and frequent urination are not indicative of heart failure. The client should report these symptoms to his physician. (C) Drowsiness and lethargy are not indicative of worsening heart failure. The client should report these symptoms to his physician. (D) All of these symptoms indicate a worsening cardiac condition possibly associated with too much activity. The client's activity level should be evaluated.
NEW QUESTION # 248
A client presents to the emergency room with cyanosis, coughing, tachypnea, and tachycardia. She has a history of asthma. Arterial blood gas values are pH 7.28, PaO2 54, PaCO2 60, and HCO3 24. The nursing assessment of arterial blood gases indicate the presence of:
- A. Respiratory acidosis
- B. Metabolic alkalosis
- C. Respiratory alkalosis
- D. Metabolic acidosis
Answer: A
Explanation:
Section: Questions Set D
Explanation:
(A) Respiratory alkalosis is determined by elevated pH and low PaCO2. (B) Respiratory acidosis is determined by low pH and elevated PaCO2. (C) Metabolic alkalosis is determined by elevated pH and HCO3. (D) Metabolic acidosis is determined by low pH and HCO3.
NEW QUESTION # 249
A 4-year-old child has Down syndrome. The community health nurse has coordinated a special preschool program. The nurse's primary goal is to:
- A. Prepare child to enter mainstream education
- B. Provide a demanding and challenging educational program
- C. Provide respite care for the mother
- D. Facilitate optimal development
Answer: D
Explanation:
Explanation
(A) Respite care for the family may be needed, but it is not the primary goal of a preschool program. (B) Facilitation of optimal growth and development is essential for every child. (C) A demanding and challenging educational program may predispose the child to failure. Children with retardation should begin with simple and challenging educational programs. (D) Mental retardation associated with Down syndrome may not permit mainstream education. A preschoolprogram's primary goal is not preparation for mainstream education but continuation of optimal development.
NEW QUESTION # 250
A 35-year-old client is receiving psychopharmacological treatment of his major depression with tranylcypromine sulfate (Parnate), a monoamine oxidase (MAO) inhibitor. The nurse teaches the client that while he is taking this type of antidepressant, he needs to restrict his dietary intake of:
- A. Tryptophan
- B. Saturated fats
- C. Tyramine
- D. Potassium-rich foods
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) The client may need to avoid some potassium-rich foods (such as bananas, raisins, etc.). However, this is not because of the potassium content of these foods. (B) Tryptophan is an essential amino acid that is present in high concentrations in animal and fish protein. (C) The client will need to watch his dietary intake of tyramine. Tyramine is a by-product of the conversion of tyrosine to epinephrine. Tyramine is found in a variety of foods and beverages, ranging from aged cheese to caffeine drinks. Ingestion of tyramine-rich foods while taking a MAO inhibitor may lead to an increase in blood pressure and/or a life- threatening hypertensive crisis. (D) To maintain a healthy lifestyle, restriction of dietary saturated fats is advisable.
NEW QUESTION # 251
A 49-year-old obese woman has been admitted to the general surgery unit with choledocholithiasis. As the nurse is admitting her to the unit, she states, "The doctor said I have stones that need to be removed; where are they?" The nurse knows that the best explanation for this is to tell her that:
- A. There are no stones, but her gallbladder is irritated and caused her nausea, vomiting, and pain
- B. There are stones present in her common bile duct
- C. There are stones present in her gallbladder
- D. There are stones present in her kidneys
Answer: B
Explanation:
Explanation
(A)Cholelithiasisis the correct term used to describe the presence of stones in the gallbladder.
(B)Nephrolithiasis,orrenal calculi,is the correct term used to describe the presence of stones in the kidney.
(C)Choledocholithiasisis the correct term used to describe the presence of stones in the common bile duct.
(D)Cholecystitisis the correct term used to describe inflammation of the gallbladder and can be associated with cystic duct obstructions from impacted stones.
NEW QUESTION # 252
On an assessment of a client's mouth, the nurse notices white patches on the buccal mucosa. The nurse tries to obtain a sample for a culture, but the lesion cannot be rubbed off. The nurse would suspect that this lesion is:
- A. Candidiasis
- B. Stomatitis
- C. Xerosteromia
- D. Leukoplakia
Answer: D
Explanation:
(A) Xerostomia is dry mouth. (B) Candidiasis can be rubbed off, but it will bleed. (C)
Leukoplakia cannot be rubbed off. (D) Stomatitis is caused by candidiasis and gram-negative bacteria.
NEW QUESTION # 253
After 7 hours in restraints and a total of 30-mg haloperidol in divided doses, a client complains of stiffness in his neck and his tongue "pulling to one side." These extrapyramidal symptoms (EPS) will most likely be relieved by the administration of:
- A. Flurazepan (Dalmane)
- B. Thiothixene (Navane)
- C. Lorazepam (Ativan)
- D. Benztropine (Cogentin)
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Lorazepam is an antianxiety agent that produces muscle relaxation and inhibits cortical and limbic arousal. It has no action in the basal ganglia of the brain. (B) Benztropine acts to reduce EPS by blocking excess CNS cholinergic activity associated with dopamine deficiency in the basal ganglia by displacing acetylcholine at the receptor site. (C) Thiothixene is an antipsychotic known to block dopamine in the limbic system, thereby causing EPS. (D) Flurazepan is a hypnotic that acts in the limbic system, thalamus, and hypothalamus of the CNS to produce sleep. It has no known action in the vasal ganglia.
NEW QUESTION # 254
Degenerative disorders are attributed to many factors. As a nurse assigned to a convalescent home, one must often educate families about how such conditions occur. Which of the following statements might the nurse need to explore when a daughter tries to explain to her mother what caused her degenerative disorder?
- A. "Perhaps, it's the way your parents used those double- bind messages, Mother."
- B. "It can be caused by lots of things, toxic agents and even alcohol, Mother."
- C. "I know some people who are having this problem and they were exposed to chemicals at work, Mother."
- D. "Some folks believe that aging causes this, Mother."
Answer: A
Explanation:
Explanation
(A) Aging is a factor in the cause of degenerative disorders. (B) Double-bind messages may be found in the histories of families of individuals who develop schizophrenia, but they are not related to degenerative disorders. (C) Chemicals (toxic agents) in work environments are predisposing factors to degenerative disorders. (D) Alcohol causes some degenerative disorders, such as Wernicke's syndrome.
NEW QUESTION # 255
Discharge teaching was effective if the parents of a child with atopic dermatitis could state the importance of:
- A. Wrapping hands in soft cotton gloves
- B. Maintaining a high-humidified environment
- C. Furry, soft stuffed animals for play
- D. Showering 3-4 times a day
Answer: A
Explanation:
Explanation
(A) Maintaining a low-humidified environment. (B) Avoiding furry, soft stuffed animals for play, which may increase symptoms of allergy. (C) Avoiding showering, which irritates the dermatitis, and encouraging bathing
4 times a day in colloid bath for temporary relief. (D) Wrapping hands in soft cotton gloves to prevent skin damage during scratching.
NEW QUESTION # 256
Before giving methergine postpartum, the nurse should assess the client for:
- A. Decreased amount of lochial flow
- B. Afterpains
- C. Flushing
- D. Elevated blood pressure
Answer: D
Explanation:
Explanation
(A) Methergine is given to contract the uterus and to control postpartal hemorrhage; therefore, lochial flow should decrease. (B) Methergine may elevate the blood pressure. A client with an elevated blood pressure should not receive methergine, but she could be given oxytocin if necessary. (C) Flushing is not a side effect of methergine. (D) Afterpains are increased with methergine usage. The client should be informed that this is a normal response.
NEW QUESTION # 257
The nurse notes hyperventilation in a client with a thermal injury. She recognizes that this
may be a reaction to which of the following medications if applied in large amounts?
- A. Povidone-iodine
- B. Neosporin sulfate
- C. Silver sulfadiazine
- D. Mafenide acetate
Answer: D
Explanation:
(A) The side effects of neomycin sulfate include rash, urticaria, nephrotoxicity, and ototoxicity. (B) The side effects of mafenide acetate include bone marrow suppression, hemolytic anemia, eosinophilia, and metabolic acidosis. The hyperventilation is a compensatory response to the metabolic acidosis. (C) The side effects of silver sulfadiazine include rash, itching, leukopenia, and decreased renal function. (D) The primary side effect of povidone- iodine is decreased renal function.
NEW QUESTION # 258
A 47-year-old client comes to the emergency department complaining of moderate flank, abdominal, and testicular pain with nausea of 4 hours' duration. After physical examination and obtaining the client's history, the physician suspects urethral obstruction by calculi. The nurse realizes that the physician will order which one of the following diagnostic studies to best confirm the diagnosis?
- A. Cystoscopy
- B. Ureterolithotomy
- C. Intravenous pyelogram with excretory urogram
- D. Kidneys, ureter, bladder, x-ray of abdomen
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Cystoscopy is an endoscopic procedure that uses an instrument (a cystoscope) to visualize the internal bladder and ureter structures and to capture and remove an obstructing stone. (B) Kidney, ureter, bladder x-ray is used to outline gross structural changes in the kidneys, ureter, and bladder and will determine the general location of a stone. (C) An intravenous pyelogram with excretory urogram is used to visualize the kidneys, kidney pelvis, ureters, and bladder. This procedure is used specifically to determine whether urethral obstruction is partial or complete; it shows the exact location of the stone and dilation of the ureter above the stone. (D) Ureterolithotomy is a surgical procedure in which the ureter is incised and the stone is manually removed because the stone is unable to pass through the ureter independently.
NEW QUESTION # 259
A pregnant client during labor is irritable and feels the urge to vomit. The nurse should recognize this as the:
- A. Fourth stage of labor
- B. Transition stage of labor
- C. Third stage of labor
- D. Second stage of labor
Answer: B
Explanation:
Explanation
(A) The fourth stage begins after expulsion of the placenta. Client symptoms are: fatigue; chills; scant, bloody vaginal discharge; and nausea. (B) The third stage is from birth to expulsion of placenta. Client symptoms are uterine contractions, gush of blood, and perineal pain. (C) The transition stage is characterized by strong uterine contractions and cervical dilation. Clientsymptoms are irritability, restlessness, belching, muscle tremors, nausea, and vomiting. (D) The second stage is characterized by full dilation of cervix. Client symptoms are perineal bulge, pushing with contractions, great irritability, and leg cramps.
NEW QUESTION # 260
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