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Questions 149

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Question 1 of 5

A client with a history of diverticulitis complains of abdominal pain, fever, and diarrhea. Which food is responsible for the client's symptoms?

Correct Answer: D

Rationale: Whole-grain cereal, high in fiber, can irritate diverticula, causing inflammation and symptoms like pain, fever, and diarrhea.

Question 2 of 5

The nurse is performing discharge instruction for a client with an implantable permanent pacemaker. What discharge instruction is an essential part of the plan?

Correct Answer: C

Rationale: Clients with pacemakers must monitor their pulse to ensure the device is functioning correctly and to detect irregularities, making pulse-taking an essential discharge instruction.

Question 3 of 5

The elderly client is admitted to the emergency room. Which symptom is the client with a fractured hip most likely to exhibit?

Correct Answer: B

Rationale: Disalignment is a hallmark sign of a hip fracture due to bone displacement.

Question 4 of 5

A nurse is administering a blood transfusion to a client on the oncology unit. Which clinical manifestation indicates an acute hemolytic reaction to the blood?

Correct Answer: A

Rationale: Low back pain is a hallmark of acute hemolytic transfusion reaction due to hemolysis and kidney involvement. Fever, urticaria, or neck vein distention suggest other complications.

Question 5 of 5

A client delivered a 9-pound infant 2 hours ago. The client has an IV of D5W with oxytocin. The nurse determines that the medication is achieving the desired effect when she observes:

Correct Answer: D

Rationale: Oxytocin promotes uterine contractions, resulting in a firm fundus, which prevents postpartum hemorrhage and is the desired effect.

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