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Questions 158

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Question 1 of 5

The following nursing diagnosis is written for a comatose client with cirrhosis of the liver and secondary splenomegaly--High risk for injury: Increased susceptibility to bleeding related to:

Correct Answer: B

Rationale: There is a decreased absorption of vitamin K with cirrhosis of the liver. This decrease impairs blood coagulation and the formation of prothrombin. Thrombocytopenia, an increased destruction of platelets, occurs secondary to hypersplenism. A diminished function of the Kupffer cells occurs with cirrhosis of the liver, causing the client to become more susceptible to infections. A decrease in the synthesis of fibrinogen and clotting factors VII, IX, and X occurs with cirrhosis of the liver and increases the susceptibility to bleeding.

Question 2 of 5

A client with pregnancy-induced hypertension is scheduled for a C-section. Before surgery, the nurse should keep the client:

Correct Answer: C

Rationale: The left lateral position improves uteroplacental blood flow in pregnancy-induced hypertension, reducing fetal distress risk. Right-sided, supine, or knee-chest positions are less optimal.

Question 3 of 5

A successful executive left her job and became a housewife after her marriage to a plastic surgeon. She started doing volunteer work for a charity organization. She developed pain in her legs that advanced to the point of paralysis. Her physicians can find no organic basis for the paralysis. The client's behavior can be described as:

Correct Answer: C

Rationale: A conversion reaction is a physical expression of an emotional conflict with no organic basis, such as paralysis in this case.

Question 4 of 5

A client is admitted with suspected Hodgkin's lymphoma. The diagnosis is confirmed by the:

Correct Answer: B

Rationale: Hodgkin's lymphoma is diagnosed by the presence of Reed-Sternberg cells in lymph node biopsy, a hallmark of the disease.

Question 5 of 5

The physician has ordered a 24-hour urine collection for a client. Which instruction should the nurse provide?

Correct Answer: A

Rationale: For a 24-hour urine collection, the first void is discarded, and all subsequent urine is collected for exactly 24 hours to ensure accurate measurement of analytes. A single container is used, refrigeration is advised, but separate voids are not needed.

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