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Questions 149

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Question 1 of 5

An 82-year-old female complains of generalized fatigue and has new onset of urinary incontinence as well as anorexia, hyperventilation, and low-grade fever. The nurse anticipates that the client will be evaluated for which of the following?

Correct Answer: C

Rationale: Symptoms of fatigue, urinary incontinence, anorexia, and low-grade fever in an elderly female are classic for a urinary tract infection (
C). Diabetes (
A), bladder cancer (
B), and influenza (
D) are less likely to present with this combination of symptoms.

Question 2 of 5

The nurse is caring for a client with a tracheostomy tube in place. During tracheostomy care, the nurse accidentally dislodges the tube. Which of the following actions should the nurse take FIRST?

Correct Answer: A

Rationale: immediate reinsertion of a tracheostomy tube is critical to maintain airway patency

Question 3 of 5

A young adult patient constantly seeks attention from the nurses, stomping away from the nurses’ station and pouting when her requests are refused. Which of the following responses by the nurse is MOST appropriate?

Correct Answer: B

Rationale: reward nonseeking attention behaviors by giving the patient unsolicited attention

Question 4 of 5

A client with alcoholism has been instructed to increase his intake of thiamine. The nurse knows the client understands the instructions when he selects which food?

Correct Answer: D

Rationale: Sliced pork is a rich source of thiamine (vitamin B1), which is critical for preventing Wernicke's encephalopathy in clients with alcoholism.

Question 5 of 5

The parents of a one-month-old boy bring their son to the clinic for evaluation of a possible right dislocated hip. If a diagnosis of unilateral dislocation of the right hip is made, which of the following symptoms will the nurse observe?

Correct Answer: B

Rationale: folds and creases will be longer and deeper on affected side

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