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Questions 157

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Question 1 of 5

The client is admitted with a diagnosis of gestational trophoblastic disease. Which vital sign change is most likely to be observed?

Correct Answer: A

Rationale: Gestational trophoblastic disease can cause maternal tachycardia due to elevated hCG or bleeding. Fetal bradycardia is not relevant (no viable fetus) and hypotension is less common unless hemorrhage occurs.

Question 2 of 5

A client diagnosed with severe anemia is to receive 2 U of packed red blood cells. Prior to starting the blood transfusion, the nurse must:

Correct Answer: A

Rationale: A baseline set of vital signs is necessary to determine if any transfusion reactions occur as the blood product is being administered. The only companion fluid to be used during a blood transfusion is normal saline. The calcium in Ringer's lactate can cause clotting. Only a blood administration set should be used. A microdrip tube would cause lysis of the red blood cells. Proper identification of the recipient and the blood product must be validated by at least two people.

Question 3 of 5

What is the most effective method to identify early breast cancer lumps?

Correct Answer: D

Rationale: Mammograms are less effective than breast self-examination for the diagnosis of abnormalities in younger women, who have denser breast tissue. They are more effective for women older than 40. Up to 15% of early-stage breast cancers are detected by physical examination; however, 95% are detected by women doing breast self-examination. Ultrasound is used primarily to determine the location of cysts and to distinguish cysts from solid masses. Monthly breast self-examination has been shown to be the most effective method for early detection of breast cancer. Approximately 95% of lumps are detected by women themselves.

Question 4 of 5

A 66-year-old female client has smoked 2 packs of cigarettes per day for 20 years. Her arterial blood gases on room air are as follows: pH 7.35; PO2 70 mm Hg; PCO2 55 mm Hg; HCO3 32 mEq/L. These blood gases reflect:

Correct Answer: B

Rationale: Normal pH with elevated PCO2 and HCO3 indicates compensated respiratory acidosis, common in chronic smokers due to CO2 retention.

Question 5 of 5

The nurse is assessing a client with suspected rheumatoid arthritis. Which finding is most characteristic of this condition?

Correct Answer: A

Rationale: Morning stiffness lasting over 30 minutes is a hallmark of rheumatoid arthritis, reflecting synovial inflammation. Joint pain is symmetrical, fever and weight loss are less specific, and nodules are subcutaneous, not spinal.

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