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Questions 149

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Question 1 of 5

An important intervention in monitoring the dietary compliance of a client with bulimia is:

Correct Answer: C

Rationale: Observing the client after meals prevents purging, a common behavior in bulimia, ensuring dietary compliance and safety.

Question 2 of 5

The 6-month-old client with a ventral septal defect is receiving Digitalis for regulation of his heart rate. Which finding should be reported to the doctor?

Correct Answer: C

Rationale: A heart rate of 60 bpm in a 6-month-old is too low (normal is 80-160 bpm), indicating possible digitalis toxicity, which should be reported.

Question 3 of 5

The nurse is monitoring a client with schizophrenia who is prescribed aripiprazole (Abilify). During a multidisciplinary mental health team meeting, which symptoms should be brought to the psychiatrist's attention? Select all that apply.

Correct Answer: A,C

Rationale: Uncontrolled facial movements and stiff muscles suggest extrapyramidal side effects or tardive dyskinesia, serious side effects of aripiprazole requiring psychiatrist attention.

Question 4 of 5

A client pushes his call light and tells the nurse his chest is hurting. The nurse sees his oxygen saturation is 88%. The nurse's first intervention is to

Correct Answer: B

Rationale: Hypoxemia (SpO2 88%) requires immediate oxygen administration to improve oxygenation, which is the priority for chest pain before further assessment or intervention.

Question 5 of 5

Where is the best site for examining for the presence of petechiae in an African American client?

Correct Answer: C

Rationale: The earlobes are a reliable site to assess petechiae in dark-skinned individuals, as they are less pigmented and allow easier visualization of small hemorrhages.

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