After a motor vehicle accident, Armand, a 22-year-old client, is admitted with a pneumothorax. The surgeon inserts a chest tube and attaches it to a chest drainage system. Bubbling soon appears in the water seal chamber. Which of the following is the most likely cause of the bubbling? A. Air leak B. Adequate suction … Read More »
While performing a physical assessment of a male client with gout of the great toe, Nurse Vivian should assess for additional tophi (urate deposits) on the: A. Buttocks B. Ears C. Face D. Abdomen Correct Answer: B. Ears Uric acid has a low solubility, it tends to… Read More »
A client is in her third month of her first pregnancy. During the interview, she tells the nurse that she has several sex partners and is unsure of the identity of the baby’s father. Which of the following nursing interventions is a priority?A. Counsel the woman to consent to HIV screening. A. Counsel the… Read More »
A patient received surgery and chemotherapy for colon cancer, completing therapy 3 months previously, and she is now in remission. At a follow-up appointment, she complains of fatigue following activity and difficulty with concentration at her weekly bridge games. Which of the following explanations would account for her symptoms? A. The symptoms may be… Read More »
Which of the following complications of an abdominal aortic repair is indicated by detection of a hematoma in the perineal area? A. Hernia B. Stage 1 pressure ulcer C. Retroperitoneal rupture at the repair site D. Rapid expansion of the aneurysm Correct Answer: C. Retroperitoneal rupture at… Read More »
Cristina undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, N0, M0. What does this classification mean? A. No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis. B. Carcinoma in situ, no abnormal… Read More »
Wilfredo with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse Patricia position the client for this test initially? A. Lying on the right side with legs straight. B. Lying on the left side with knees bent. C. Prone with the torso elevated. D. Bent… Read More »
A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal? A. 11-year-old male: 90 BPM, 22 RPM, 100/70 mmHg B. 13-year-old female: 105 BPM, 22 RPM, 105/50 mmHg C. 5-year-old male: 102 BPM, 24 RPM, 90/65 mmHg D. 6-year-old female: 100 BPM, 26 RPM, 90/70… Read More »
Lydia undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction? A. “Keep the stoma uncovered.” B. “Keep the stoma dry.” C. “Have a family member perform stoma care initially until you get used to the procedure.” … Read More »
A male client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, Nurse Oliver notes that the client’s stoma appears dusky. How should the nurse interpret this finding? A. Blood supply to the stoma has been interrupted. B. This is a normal finding 1 day after surgery. C.… Read More »