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Questions 158

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Question 1 of 5

A female client who has chronic obstructive pulmonary disease (COPD) has presented in the emergency department with cough productive of yellow sputum and increasing shortness of breath. On room air, her blood gases are as follows: pH 7.30 mm Hg, PCO2 60 mm Hg, PO2 55 mm Hg, HCO3 32 mEq/L. These arterial blood gases reflect:

Correct Answer: D

Rationale: Low pH, high PCO2, and normal HCO3 indicate uncompensated respiratory acidosis, reflecting acute exacerbation of COPD.

Question 2 of 5

The mother of a child taking phenytoin will need to plan appropriate mouth care and gingival stimulation. When tooth-brushing is contraindicated, the next most effective cleansing and gingival stimulation technique would be:

Correct Answer: A

Rationale: This technique provides effective rinsing and gingival stimulation. This technique does not provide gingival stimulation. This technique provides effective rinsing but not gingival stimulation. Using peroxide is not pleasant for the child. This technique provides effective rinsing but not gingival stimulation.

Question 3 of 5

Which of the following risk factors associated with breast cancer would a nurse consider most significant in a client's history?

Correct Answer: C

Rationale: Women who begin menarche late (after 13 years old) have a lower risk of developing breast cancer than women who have begun earlier. Average age for menarche is 12.5 years. Women who have never been pregnant have an increased risk for breast cancer, but a positive family history poses an even greater risk. A positive family history puts a woman at an increased risk of developing breast cancer. It is recommended that mammography screening begin 5 years before the age at which an immediate female relative was diagnosed with breast cancer. Early menopause decreases the risk of developing breast cancer.

Question 4 of 5

The client is prescribed warfarin (Coumadin). Which food should the nurse instruct the client to limit?

Correct Answer: A

Rationale: Spinach is high in vitamin K, which antagonizes warfarin’s anticoagulant effect, potentially reducing its efficacy. Apples, chicken, and rice have negligible vitamin K.

Question 5 of 5

A client develops a temperature of 102°F following coronary artery bypass surgery. The nurse should notify the physician immediately because elevations in temperature:

Correct Answer: C

Rationale: Fever post-CABG increases metabolic demand, potentially decreasing cardiac output in a compromised heart, requiring immediate attention. Tamponade and rejection have other signs.

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