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Questions 164

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Extract:


Question 1 of 5

A client who has been waiting for several hours in the clinic waiting room suddenly begins to shout, 'I need some attention and I need it now!' How should the nurse respond initially?

Correct Answer: C

Rationale: Engaging the client to assess her needs de-escalates agitation and addresses concerns. Silencing, calling security, or explaining delays may escalate tension.

Extract:

Laboratory reference ranges
1-hour glucose screen - Gestational diabetes
<140 mg/dL
(<7.8 mmol/L)
Hemoglobin (pregnant)
>11.0 g/dL
(>110 g/L)
WBC (pregnant)
5000-15,000/mm3
(5-15 × 109/L)


Question 2 of 5

The licensed practical nurse (LPN) is collecting data on several clients in the antepartum unit. Which of the following clients should the LPN report to the registered nurse for further assessment?

Correct Answer: B

Rationale: Hemoglobin of 9 g/dL (
B) indicates anemia, requiring further assessment. Normal glucose (
A), reactive nonstress test (
C), and slightly elevated WBC (
D) are less urgent.

Extract:


Question 3 of 5

The practical nurse is assisting the registered nurse in assessing a child with attention-deficit hyperactivity disorder at the clinic for a well-child visit. The client has been taking methylphenidate for a year. What are the priority nursing assessments?

Correct Answer: C

Rationale: Methylphenidate can affect growth (height/weight) and increase blood pressure (
C), making these priority assessments. Attention and activity (
A) are relevant but secondary. Dental health (
B) and social progress (
D) are less critical for medication monitoring.

Question 4 of 5

An alert adult is being admitted for elective surgery. Which comment made by the client indicates a need for more instruction regarding advance directives?

Correct Answer: B

Rationale: Advance directives allow clients to specify care preferences, not relinquish decision-making entirely. This comment suggests a misunderstanding that requires further education.

Question 5 of 5

Because the client has hypothyroidism, the nurse expects which of the following to be present in the client?

Correct Answer: C

Rationale: Hypothyroidism slows metabolism, causing hypothermia (e.g., 96.8°F). Weight gain, not loss, slow respirations, and heavy menses are typical.

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