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Question 1 of 5

After a discharge, there is a private room available on the floor. The nurse should move which client to the private room?

Correct Answer: B

Rationale: Pityriasis rosea is a potentially contagious rash, warranting a private room to prevent spread. The other conditions are not infectious.

Question 2 of 5

While caring for a client with hypertension, the nurse notes the following vital signs: BP of 140/20, pulse 120, respirations 36, temperature 100.8°F. The nurse's initial action should be to:

Correct Answer: B

Rationale: Rechecking vital signs ensures accuracy, as the low diastolic BP may be an error, and guides further action.

Question 3 of 5

A client is admitted to the chemical dependency unit for poly-drug abuse. The client states, 'I don't know why you are all so worried; I am in control. I don't have a problem.' Which defense mechanism is being utilized?

Correct Answer: D

Rationale: Denial is the defense mechanism where the client refuses to acknowledge the reality of their substance abuse problem, minimizing its severity.

Question 4 of 5

A client is diagnosed with stage II Hodgkin's lymphoma. The nurse recognizes that the client has involvement:

Correct Answer: B

Rationale: Stage II Hodgkin's lymphoma involves two or more lymph nodes or a single organ on the same side of the diaphragm, per the Ann Arbor staging system.

Question 5 of 5

A client with suspected leukemia is to undergo a bone marrow aspiration. The nurse plans to include which statement in the teaching session?

Correct Answer: B

Rationale: Bone marrow aspiration can cause pain or discomfort during needle insertion and aspiration. Informing the client prepares them for the procedure and helps manage expectations.

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