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Questions 149

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Extract:


Question 1 of 5

The home health nurse is visiting a client with Paget's disease. An important part of preventive care for the client with Paget's disease is:

Correct Answer: A

Rationale: Paget's disease increases fracture risk, so keeping the environment clutter-free reduces fall risks, a key preventive measure.

Question 2 of 5

A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most appropriate action for the nurse to take?

Correct Answer: A

Rationale: Calling security and preparing for sedation ensures the safety of the client, other patients, and staff during an uncontrolled rage.

Question 3 of 5

The nurse is assessing a client who is 36 hours postpartum. Which of the following findings would indicate a need for further evaluation?

Correct Answer: D

Rationale: a temperature of 100.4°F may indicate infection, such as endometritis, and requires further evaluation

Question 4 of 5

A client in ICU has a chest tube, and the nurse is assessing the chest tube drainage system. The nurse notices intermittent bubbling in the water seal chamber. What action should the nurse take?

Correct Answer: B

Rationale: Intermittent bubbling in the water seal chamber is normal during inspiration/expiration or coughing, indicating a patent system. It should be documented as a normal finding.

Question 5 of 5

The client is taking prednisone 7.5 mg po each morning to treat his systemic lupus erythematosis. Which statement best explains the reason for taking the prednisone in the morning?

Correct Answer: D

Rationale: Morning dosing aligns with the body's natural cortisol peak, minimizing adrenal suppression.

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