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Questions 158

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Question 1 of 5

The physician orders the removal of an in-dwelling catheter the second post-operative day for a client with a prostatectomy. The client complains of pain and dribbling of urine the first time he voids. The nurse should tell the client that:

Correct Answer: D

Rationale: Pain and dribbling post-catheter removal after prostatectomy are common due to bladder irritation and will improve with time. Compresses, exercises, or reinsertion are not typically needed.

Question 2 of 5

A 38-year-old female client with a history of chronic schizophrenia, paranoid type, is currently an outpatient at the local mental health and mental retardation clinic. The client comes in once a week for medication evaluation and/or refills. She self-administers haloperidol 5 mg twice a day and benztropine 1 mg once a day. During a recent clinic visit, she says to the nurse, 'I can't stay still at night. I toss and turn and can't fall asleep.' The nurse suspects that she may be experiencing:

Correct Answer: A

Rationale: Akathisia, or motor restlessness, is a reversible EPS frequently associated with the administration of antipsychotic drugs such as haloperidol. Akinesia, or muscular or motor retardation, is an example of reversible EPS frequently associated with the administration of major tranquilizers such as haloperidol. Acute dystonic reactions, bizarre and severe muscle contractions usually of the tongue, face, neck or extraocular muscles, are examples of EPS. Opisthotonos, a severe type of whole-body dystonic reaction in which the head and heels are bent backward while the body is bowed forward, is an example of EPS.

Question 3 of 5

When assessing a female child for Turner's syndrome, the nurse observes for which of the following symptoms?

Correct Answer: B

Rationale: This syndrome is caused by absence of one of the X chromosomes. These children are short in stature. Amenorrhea is a symptom of Turner's syndrome, which appears at puberty. Sexual infantilism is characteristic of this syndrome. Gynecomastia is a symptom in Klinefelter's syndrome.

Question 4 of 5

The client is receiving a continuous infusion of propofol (Diprivan) for sedation. Which assessment is most important?

Correct Answer: A

Rationale: Propofol can cause respiratory depression, so monitoring respiratory rate is critical to detect apnea or hypoventilation. Blood pressure, pulse, and temperature are monitored but are less immediate concerns.

Question 5 of 5

Which statement describes the contagious stage of varicella?

Correct Answer: D

Rationale: Varicella (chickenpox) is contagious from 1-2 days before the rash until all lesions are crusted, as the virus is shed during this period. Earlier or later stages are less contagious.

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