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Questions 164

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Question 1 of 5

A client was re-admitted to the hospital following a recent skull fracture. Which finding requires the nurse's immediate attention?

Correct Answer: A

Rationale: Lethargy. The level of consciousness or responsiveness is the most important measure of the client's rising intracranial pressure, requiring immediate attention.

Question 2 of 5

Prior to discharge from the postanesthesia care unit following a vein stripping of the left leg, the nurse should tell the client to:

Correct Answer: B

Rationale: Elevating legs or walking promotes venous return, while avoiding prolonged standing/sitting prevents stasis post-vein stripping. Heat, non-weight bearing, and early bandage removal are not recommended.

Question 3 of 5

A client with tuberculosis has an order for Rifadin (rifampin). What vitamin is usually given with rifampin?

Correct Answer: B

Rationale: Pyridoxine (vitamin B6) is given with rifampin to prevent peripheral neuropathy, a side effect. Other vitamins are not typically associated with rifampin therapy.

Question 4 of 5

The nurse is caring for a client who has a pulmonary embolism. Which of the following findings would the nurse expect to observe? Select all that apply.

Correct Answer: A,B,C,D

Rationale: Pulmonary embolism obstructs pulmonary arteries, causing dyspnea, chest pain, tachypnea, and hypoxemia. Bradycardia is unlikely; tachycardia is typical. Tracheal deviation is associated with tension pneumothorax, not embolism.

Question 5 of 5

The nurse is reinforcing teaching about ulcer prevention with a client newly diagnosed with peptic ulcer disease. Which of the following client statements indicate appropriate understanding of teaching? Select all that apply.

Correct Answer: A,B,C,D

Rationale: Avoiding NSAIDs (ibuprofen), excess coffee/cola, smoking, and alcohol reduces ulcer irritation and promotes healing. Whole wheat foods are beneficial for digestion and not contraindicated.

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