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Questions 149

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Question 1 of 5

A post-operative client with an abdominal wound tries to reach over and take a book off the bedside table. He immediately screams and calls for the nurse. The nurse notices serosanguineous drainage coming from the incision on the abdomen. The first action the nurse should take is to

Correct Answer: A

Rationale: Covering the incision with a sterile dressing prevents contamination and infection, which is the immediate priority. Assessing vitals or notifying the surgeon follows after stabilizing the wound.

Question 2 of 5

Which activity is best suited to the 12-year-old with juvenile rheumatoid arthritis?

Correct Answer: B

Rationale: Swimming is low-impact, promoting joint mobility and muscle strength without stressing joints in juvenile rheumatoid arthritis.

Question 3 of 5

A 42-year-old female has thrombocytopenia with a platelet count of 75,000. The nurse should

Correct Answer: A

Rationale: Thrombocytopenia (platelets <150,000) increases bleeding risk. Monitoring for bleeding (e.g., bruising, petechiae) is the priority.

Question 4 of 5

The nurse is evaluating cerebral perfusion outcomes for a client with a subdural hematoma. The nurse evaluates which of the following as a favorable outcome for this client?

Correct Answer: A

Rationale: An arterial blood gas POâ‚‚ of 98 indicates adequate oxygenation, supporting cerebral perfusion, which is a favorable outcome for a subdural hematoma.

Question 5 of 5

The client is receiving heparin for thrombophlebitis of the left lower extremity. Which of the following drugs reverses the effects of heparin?

Correct Answer: B

Rationale: Protamine sulfate neutralizes heparin's anticoagulant effect.

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