单选题A client, now 37 weeks pregnant, calls the clinic because she's concerned about being short of breath and is unable to sleep unless she places three pillows under her head. After listening to her concerns, the nurse should take which action? A. Make an appointment because the client needs to be evaluated. B. Explain that these are expected problems for the latter stages of pregnancy. C. Arrange for the client to be admitted to the birth center for delivery. D. Tell the client to go to the hospital; she may be experiencing signs of heart failure from a 45% to 50% increase in blood volume.
单选题During the first month in a nursing home, an elderly client demonstrates numerous behaviors related to disorientation and cognitive impairment. The nurse's plan for care should continue to take into consideration the A.Assessment of the client's orientation to time, place, and person B.Realistic ability of the client to perform without becoming frustrated C.Identification of stressors that appear to precipitate the client's disruptive behavior D.Fact that the client's cognitive impairment will increase until adjustment to the home is accomplished
单选题The nurse assesses the client's burned right arm and notes increasing edema, absence of a radial pulse, and decreased sensation in the fingers. What should be the nurse's priority response? A. Document findings and recheck in 1 hour. B. Elevate extremity on one pillow. C. Implement passive range-of-motion exercises. D. Notify the physician immediately.
单选题The child with rheumatic fever must have his heart rate measured while
awake and while sleeping. Why are two readings necessary?
A. To obtain a heart rate that isn't affected by medication.
B. To eliminate interference from the jerky movements of chorea.
C. To ensure that the child can't consciously raise or lower the heart
rate.
D. To compensate for the effects of activity on the heart rate.
单选题The overweight adolescent client tells the nurse that he would like to lose weight and asks the nurse's opinion on how to accomplish his goal. Which of the following suggestions would be most appropriate? A. Exercising more often. B. Severely limiting calorie intake. C. Participating in an adolescent weight-reduction program. D. Cutting clown on sweets and other snacks.
单选题A client complains of a severe, throbbing headache following a lumbar puncture. The priority nursing intervention for this client is to
单选题When caring for clients demonstrating manic behavior, the nurse must he aware of these clients' physical needs. This is particularly important because A.Left alone, these clients will withdraw to their rooms B.These clients have difficulty making their needs known C.These clients may gain too much weight from overeating D.The danger of exhaustion is always present for these clients
单选题One day, the nurse sits by a depressed client's bed and states, "I
will be spending some time with you today. " The client responds angrily, "Go
talk to someone else. They need you more. " The most therapeutic response by the
nurse would he:
A."Why are you angry with me?"
B."I'll go, but I will be back tomorrow. "
C."Don't say that. You are important, too. "
D."I will be spending the next 15 minutes with you. "
单选题The nurse instructs the client with hemorrhoids about how to decrease the discomfort. Which of the following interventions would be most likely recommended by the nurse? A. Decrease fiber in the diet. B. Decrease physical activity. C. Take laxatives to promote bowel movements. D. Use warm sitz baths.
单选题Extremely depressed clients seem to do best in settings where they have: A.Many varied activities B.A great deal of stimuli C.A simple daily schedule D.To make only simple decisions
单选题The nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation rapidly drops. He complains of shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax include A. diminished or absent breath sounds on the affected side. B. paradoxical chest wall movement with respirations. C. tracheal deviation to the unaffected side. D. muffled or distant heart sounds.
单选题The skin lesions evident in herpes zoster are similar to those seen in which disease? A. Impetigo. B. Syphilis. C. Varicella. D. Rubella.
单选题During a routine follow-up examination, the nurse updates the client’s medication history. The client currently receives prednisone therapy. Concomitant use of an agent from which of the following classes could increase the risk of peptic ulcer disease()
单选题Which vaginal infection doesn't require treatment for sexual partners? A. Neisseria gonorrhoeae. B. Candida albicans. C. Trichomonas vaginalis. D. Chlamydia trachomatis.
单选题The nurse plans to administer an injection of heparin to a client. Which of the following techniques for heparin administration is appropriate? A. Selects a 1.5-inch, 21-gauge needle for the injection. B. Makes the injection into the deltoid muscle. C. Applies gentle pressure to the site for 5 to 10 seconds after the injection. D. Aspirates with the plunger to check for entry into the blood vessel before injecting the heparin.
单选题The nurse is irrigating a client's colostomy when the client complains of abdominal cramping after receiving about 100 mL of the irrigating solution. What should the nurse do first? A. Stop the flow of solution temporarily. B. Reposition the client on to her right side. C. Remove the irrigation tube. D. Massage the abdomen gently.
单选题The nurse is interviewing a 19-year-old female at a clinic. It's her first visit, and she says that she has been exposed to herpes by her boyfriend. Initially, with primary genital or type 2 herpes simplex, the nurse would expect the client to have ().
单选题The nurse has been teaching the client strategies to prevent a recurrence of hemorrhoids. One strategy is maintaining a high-fiber diet. Which of the following breakfast menus is appropriate for the client? A. Danish pastry, prune juice, coffee, and milk. B. Oatmeal, milk, grapefruit wedges, and bran muffin. C. Corn flakes, milk, white toast, and orange juice. D. Scrambled eggs, bacon, English muffin, and apple juice.
单选题A client is admitted to the labor and delivery unit in active labor. She has had no prenatal care but appears to be between 32 and 35 weeks' gestation. History reveals that she's gravida 5, para 1, abortus 3. She tells the nurse she thinks her friend gave her a cigarette containing crack cocaine. What should the nurse do next? A. Move the precipitant delivery cart to the labor room, and notify the neonatologist on call. B. Teach the mother controlled breathing techniques. C. Call a family member to come to the hospital. D. Call the friend who gave the client the cigarette and find out exactly what the drug was.
单选题The nurse is providing care for a client with multiple myeloma, a disorder characterized by episodes of remissions and exacerbations. Which of the following resources can best help the client adapt to the disease