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Questions 149

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Question 1 of 5

The nurse is caring for a client on airborne precautions. Which of the following would the nurse expect to see in the client's medical record?

Correct Answer: A

Rationale: Measles requires airborne precautions due to its highly contagious nature via respiratory droplets, unlike the other conditions listed.

Question 2 of 5

Following a heart transplant, a client is started on medication to prevent organ rejection. Which category of medication prevents the formation of antibodies against the new organ?

Correct Answer: C

Rationale: Immunosuppressants, such as cyclosporine, prevent the immune system from forming antibodies against the transplanted heart.

Question 3 of 5

Which activity is suitable for a client who suffered an uncomplicated myocardial infarction (MI) 2 days ago?

Correct Answer: A

Rationale: Sitting in a chair for short periods is appropriate 2 days post-MI to promote circulation and prevent complications, while ambulation is too strenuous.

Question 4 of 5

The nurse is assisting a client with diverticulosis to select appropriate foods. Which food should be avoided?

Correct Answer: C

Rationale: Cucumber salad contains seeds and roughage, which can irritate the colon in diverticulosis and should be avoided.

Question 5 of 5

The nurse finds that a client receiving digoxin (Lanoxin) 0.25 mg orally has an apical pulse of 54. Which of the following should the nurse do first?

Correct Answer: A

Rationale: An apical pulse of 54 is below the safe threshold (typically 60) for digoxin, indicating potential toxicity. Withholding the dose and notifying the provider is the priority.

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