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Questions 164

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Question 1 of 5

The home health nurse is caring for an 85-year-old client. It would require immediate follow-up if the client is reporting

Correct Answer: A

Rationale: A painful red area on the buttocks suggests a pressure injury, requiring immediate intervention to prevent worsening. Edema, vision loss, and memory issues are concerning but less urgent.

Question 2 of 5

The nurse talking with a client with polycythemia vera. Which of the following statements by the client would require follow-up?

Correct Answer: D

Rationale: Iron supplements can worsen polycythemia vera by increasing red blood cell production. Hydration, aspirin, and phlebotomy are appropriate management strategies.

Question 3 of 5

The RN charge nurse hands the LPN/LVN a syringe filled with medication that the RN has just drawn and asks the LPN/LVN to administer this to a client. How should the LPN/LVN respond?

Correct Answer: C

Rationale: Verifying the medication and checking the order ensures safe administration, adhering to medication safety protocols. Blind administration or refusal is unsafe or uncooperative.

Question 4 of 5

The nurse is caring for a client with Grave's disease. Which finding would indicate a complication of the client's disease?

Correct Answer: C

Rationale: Shortness of breath may indicate thyroid storm, a life-threatening complication of Grave's disease. Fatigue and increased heart rate are common symptoms, and urinary frequency is unrelated.

Question 5 of 5

The nurse is caring for several 70 to 80 year-old clients on bed rest. What is the most important measure to prevent skin breakdown?

Correct Answer: B

Rationale: Frequent turning. Frequent turning will prevent skin breakdown by relieving prolonged pressure on any one area.

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