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Question 1 of 5

An appropriate intervention for the client with suspected genitourinary trauma and visible blood at the urethral meatus is:

Correct Answer: D

Rationale: Blood at the urethral meatus suggests trauma, contraindicating catheterization. A urologist consult is necessary for specialized evaluation and management. Physiological Adaptation

Question 2 of 5

A client has returned to his room following an esophagoscopy. Before offering fluids, the nurse should give priority to assessing the client's:

Correct Answer: B

Rationale: Assessing the gag reflex is critical post-esophagoscopy to ensure the client can swallow safely, as local anesthesia may impair this reflex.

Question 3 of 5

A client with a history of Addison's disease and flulike symptoms accompanied by nausea and vomiting over the past week is brought to the facility. The client's wife reports that she noticed that he acted confused and was extremely weak when he woke up in the morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101°F (38.3°C). A diagnosis of acute adrenal insufficiency is made. Which of the following would the nurse expect to administer by I.V. infusion?

Correct Answer: B

Rationale: Emergency treatment for acute adrenal insufficiency (addisonian crisis) is I.V. infusion of hydrocortisone and saline solution. The client is usually given 100 mg of hydrocortisone in normal saline every 6 hours until his blood pressure returns to normal. Insulin isn't indicated in this situation because adrenal insufficiency is usually associated with hypoglycemia. Potassium isn't indicated because these clients are usually hyperkalemic. The client needs normal - not hypotonic - saline solution.

Question 4 of 5

Which client is at highest risk for developing a pressure ulcer?

Correct Answer: C

Rationale: 75 year-old with left sided paresthesia who is incontinent of urine and stool. Risk factors for pressure ulcers include: immobility, absence of sensation, decreased LOC, poor nutrition and hydration, skin moisture, incontinence, increased age, decreased immune response. This client has the greatest number of risk factors.

Question 5 of 5

The client presents to the clinic with a serum cholesterol of 275 mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?

Correct Answer: A

Rationale: The client taking antilipidemics should be encouraged to report muscle weakness because this is a sign of rhabdomyolysis. The medication takes effect within one month of beginning therapy, so answer B is incorrect. The medication should be taken with water. Fruit juice, particularly grapefruit juice, can decrease the drug's effectiveness, so answer C is incorrect. Liver function studies, not a CBC, should be checked prior to beginning the medication, so answer D is incorrect.

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