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Questions 158

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Extract:


Question 1 of 5

The nurse is caring for a client post-myocardial infarction on the cardiac unit. The client is exhibiting symptoms of shock. Which clinical manifestation is the best indicator that the shock is cardiogenic rather than anaphylactic?

Correct Answer: B

Rationale: Chest pain is a hallmark of cardiogenic shock due to myocardial ischemia, distinguishing it from anaphylactic shock, which typically involves urticaria or bronchospasm. Low BP (
A) and anxiety (
C) are common in both, and normal temperature (
D) is nonspecific.

Question 2 of 5

The nurse is performing an assessment on a client with a suspected diagnosis of cataracts. The chief complaint is likely to be:

Correct Answer: B

Rationale: Cataracts cause cloudy or blurry vision due to lens opacity. Eye pain, flashing lights, and redness are more associated with other conditions like glaucoma or retinal issues.

Question 3 of 5

A client with a history of hypothyroidism is admitted with complaints of fatigue. The nurse should expect the client to have:

Correct Answer: A

Rationale: Hypothyroidism slows metabolism, leading to weight gain, fatigue, and other symptoms like cold intolerance and constipation.

Question 4 of 5

Which finding is considered a risk factor in the development of leukemia?

Correct Answer: C

Rationale: Radiation exposure such as from treatment for Hodgkin’s lymphoma is a known risk factor for leukemia. Stamp collecting computer programming and a family history of stomach cancer are not established risk factors.

Question 5 of 5

A client requires log rolling after back surgery. Correctly provide the sequence of steps the nurse should follow when performing the procedure.

Order the Items

Source Container

Obtain assistance; three nurses are preferable.
Maintain client's position in alignment with pillows.
Position two nurses on the side the client will be turned to and the third nurse on the opposite side of the bed.
Designate the person at the head of the bed to be in charge of coordinating the move.
Place a pillow between the client's knees.
Move the client in one coordinated movement when the nurse at the head of the bed signals to move the client.
Instruct the client to place the arms across the chest.

Correct Answer: A, C, D, G, E, B, F

Rationale: Log rolling sequence: Obtain assistance (
A), position nurses (
C), designate leader (
D), instruct arm placement (G), place pillow (E), align with pillows (
B), move coordinately (F).

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