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Questions 163

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Question 1 of 5

A client with cancer received platelet infusions 24 hours ago. Which of the following assessment findings would indicate the most therapeutic effect from the transfusions?

Correct Answer: D

Rationale: Platelets deal with the clotting of blood. Lack of platelets can cause bleeding. Answers A, B, and C do not directly relate to platelets, so they are incorrect.

Question 2 of 5

The nurse begins to assist with ambulation of a 9-year-old client who is 1 day postoperative appendectomy when the child cries out, 'It hurts too much. I can't do it.' Which action should the nurse complete first?

Correct Answer: B

Rationale: Assessing pain level using a numeric scale is the first step to quantify the child's pain and determine the need for analgesics or other interventions. Administering analgesics without assessment is premature, delaying ambulation avoids addressing pain, and encouraging walking ignores the child's distress.

Question 3 of 5

A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that a PTCA is the

Correct Answer: C

Rationale: PTCA is performed to improve coronary artery blood flow in a diseased artery. It is performed during a cardiac catheterization.

Question 4 of 5

The nurse is collecting data from a client who delivered a full-term newborn vaginally 12 hours ago after prolonged labor. Which of the following findings would be essential to follow up?

Correct Answer: A

Rationale: Foul-smelling lochia suggests possible endometritis or infection, requiring immediate follow-up. External hemorrhoids and mild temperature elevation are common postpartum findings, and discomfort during fundal massage is expected unless accompanied by other concerning signs.

Question 5 of 5

The nurse is caring for a client with oral candidiasis who has a new prescription for nystatin oral suspension. Which of the following actions should the nurse take? Select all that apply.

Correct Answer: A,B,D,E

Rationale: For nystatin oral suspension: avoid eating/drinking for 30 minutes to ensure contact time; monitor oral membranes for treatment response; shake the bottle for proper dosing; and swish in the mouth for efficacy. Discontinuing early risks recurrence.

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