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Questions 149

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Question 1 of 5

The client with a pacemaker should be taught to:

Correct Answer: D

Rationale: Monitoring pulse rate ensures the pacemaker is functioning correctly and detects arrhythmias.

Question 2 of 5

The nurse is caring for a client 7 days post-burn injury with 60% body surface area involved. The nursing care of this client would primarily focus on:

Correct Answer: A

Rationale: At 7 days post-burn, infection is a major risk due to open wounds and immunosuppression, making meticulous infection control the primary focus.

Question 3 of 5

The nurse is assessing for abdominal pulsations in a client with a visible mass below the umbilicus. The nurse should use which technique?

Correct Answer: B

Rationale: Inspection is used to visually assess for abdominal pulsations or masses. Palpation or percussion may be used later but are not the initial technique for observing pulsations.

Question 4 of 5

The nurse is preparing a client with acquired immunodeficiency syndrome (AIDS) for discharge home. Which of the following statements by the client indicates a need for further teaching by the nurse?

Correct Answer: D

Rationale: AIDS patients cannot donate blood due to HIV transmission risk. Public activities and restrooms pose minimal risk, and sharing serving dishes is safe if not directly contaminated.

Question 5 of 5

A client hospitalized with renal calculi complains of severe pain in the right flank. In addition to complaints of pain, the nurse can expect to see changes in the client's vital signs that include:

Correct Answer: B

Rationale: Severe pain from renal calculi can cause increased blood pressure due to sympathetic nervous system activation and stress response.

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