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Questions 164

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Question 1 of 5

A client with emphysema visits the clinic. While teaching about proper nutrition, the nurse should emphasize that the client should

Correct Answer: B

Rationale: Use oxygen during meals to improve gas exchange. This supports breathing and energy needs during eating.

Question 2 of 5

The nurse is to administer a tuberculin skin test. What is the correct procedure?

Correct Answer: C

Rationale: Tuberculin skin tests are given intradermally at a 10-degree angle on the volar forearm to create a wheal, ensuring accurate reading.

Question 3 of 5

In a long term rehabilitation care unit, a client with spinal cord injury complains of a pounding headache. The client is sitting in a wheelchair watching television. Further assessment by the nurse reveals excessive sweating, a splotchy rash, pilomotor erection, facial flushing, congested nasal passages and a heart rate of 50. The nurse should perform which action next?

Correct Answer: C

Rationale: Check the client for bladder distention and the client's urinary catheter for kinks. These are findings of autonomic dysreflexia, typically initiated by a noxious stimulus below the level of injury such as a full bladder.

Question 4 of 5

The nurse in the pediatric clinic is planning to reinforce postoperative teaching to parents. The nurse should talk with the parent of which child first?

Correct Answer: A

Rationale: A foreign object in the ear (
A) poses an immediate risk of injury or infection, requiring urgent attention. Ear pain post-adenotonsillectomy (
B) is common and less urgent. School clearance (
C) and returning to sports (
D) are non-emergent.

Question 5 of 5

Immediately following a cardiac catheterization, the client asks to go to the toilet. What is the best response by the nurse?

Correct Answer: D

Rationale: Post-catheterization, bed rest is required to prevent bleeding at the insertion site; a bedpan maintains immobility.

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