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Questions 158

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Question 1 of 5

The nurse is preparing to collect a sputum specimen from the client suspected of having tuberculosis. What is the correct method for obtaining a sputum specimen?

Correct Answer: A, B, C, D

Rationale: Morning collection (
A) yieldsthough sputum is most concentrated. Three consecutive days (
B) ensure reliable tuberculosis diagnosis. Immediate transport (
C) prevents degradation. Mouth care (
D) maintains hygiene. Antiseptic rinse (E) may kill bacteria, invalidating the sample.

Question 2 of 5

Four days after admission for cirrhosis of the liver, the nurse observes the following when assessing a male client: increased irritability, asterixis, and changes in his speech pattern. Which of the following foods would be appropriate for his bedtime snack?

Correct Answer: B

Rationale: While fresh fruit is low in protein, a milkshake is a better choice as it provides carbohydrates and some protein in a form that is easier to digest, which is crucial for clients with cirrhosis to avoid ammonia buildup. A milkshake is appropriate as it provides carbohydrates, which are needed to prevent protein catabolism, and has lower protein content compared to options like peanut butter or ham, reducing the risk of ammonia accumulation. (C,
D) Both saltine crackers with peanut butter and a ham and cheese sandwich are high in protein, which can increase ammonia levels, exacerbating hepatic encephalopathy.

Question 3 of 5

A client with BPH has undergone a TURP. Which nursing interventions are parts of the client's post-operative care?

Question Image

Correct Answer: A, B, D

Rationale: Post-TURP care includes monitoring vital signs (
A), constant bladder irrigation (
B) to prevent clots, and checking for bleeding (
D). Fluid intake is encouraged (
C), and bed rest is typically 24 hours (E).

Question 4 of 5

A client with angina is being discharged with a prescription for Transderm Nitro (nitroglycerin) patches. The nurse should tell the client to:

Correct Answer: D

Rationale: Cutting a nitroglycerin patch can alter the dose by disrupting the drug delivery system, so clients should be instructed to avoid this.

Question 5 of 5

A client with angina is experiencing migraine headaches. The physician has prescribed Sumatriptan succinate (Imitrex). Which nursing action is most appropriate?

Correct Answer: A

Rationale: Sumatriptan, a triptan, is contraindicated in angina due to vasoconstrictive effects, risking coronary ischemia. Questioning the order (
A) is priority. Samples (
B), teaching (
C), and financial aid (
D) are inappropriate without resolving the contraindication.

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