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Questions 149

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Question 1 of 5

A client with hyperkalemia is admitted to the telemetry unit. Which of the following would require notification of the health care provider? Select all that apply.

Correct Answer: A, B

Rationale: Spiked T waves and bradycardia (heart rate 53) are signs of severe hyperkalemia, requiring immediate provider notification. Normal heart rate, food refusal, and adequate urinary output (30 cc/hr) are not urgent.

Question 2 of 5

A client with rheumatoid arthritis has Sjogren's syndrome. The nurse can help relieve the symptoms of Sjogren's syndrome by:

Correct Answer: B

Rationale: Sjogren's syndrome causes dry eyes, and artificial tears (eyedrops) help relieve this symptom.

Question 3 of 5

A client who has just undergone a laparoscopic cholecystectomy complains of 'free air pain.' What would be your best action?

Correct Answer: A

Rationale: Free air pain' after laparoscopic cholecystectomy is due to residual carbon dioxide in the abdomen. Ambulation helps disperse the gas and relieve pain.

Question 4 of 5

Which of the following descriptions is typical of a Parkinsonian gait?

Correct Answer: C

Rationale: Parkinsonian gait is characterized by decreased speed, poor balance, flexed posture, and shuffling steps (
C). Other descriptions (A, B,
D) do not fully capture this gait.

Question 5 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.

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