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Questions 158

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Question 1 of 5

A client with a deep decubitus ulcer is receiving therapy in the hyperbaric oxygen chamber. Before therapy, the nurse should:

Correct Answer: B

Rationale: Clean, dry skin is required before hyperbaric oxygen therapy to prevent infection and ensure effective oxygen delivery. Lotions, petroleum, or dressings can interfere or pose fire risks.

Question 2 of 5

The nurse is caring for a client with a history of a tracheoesophageal fistula. The nurse should:

Correct Answer: D

Rationale: A tracheoesophageal fistula risks aspiration, requiring restricted oral intake until surgically repaired. Positioning, suctioning, and feedings are secondary or contraindicated.

Question 3 of 5

A client with a history of Addison's disease is admitted with complaints of nausea and vomiting. The nurse should expect the client to have:

Correct Answer: A

Rationale: Addison's disease causes adrenal insufficiency, reducing aldosterone, which leads to hyperkalemia due to impaired potassium excretion.

Question 4 of 5

The client at 34 weeks gestation is admitted with a diagnosis of gestational hypertension. Which assessment finding requires immediate intervention?

Correct Answer: C

Rationale: Absence of deep tendon reflexes in gestational hypertension suggests magnesium toxicity (if receiving magnesium sulfate) or severe neurological complications requiring immediate intervention. The other findings while concerning are less urgent.

Question 5 of 5

A client with a history of atrial fibrillation is admitted with complaints of fatigue. The nurse should give priority to:

Correct Answer: A

Rationale: Fatigue in atrial fibrillation may indicate reduced cardiac output, so monitoring heart rate is the priority.

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