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Question 1 of 5

When performing an assessment on the client with emphysema, the nurse finds that the client has a barrel chest. The alteration in the client's chest is due to:

Correct Answer: B

Rationale: Clients with emphysema develop a barrel chest due to the trapping of air in the lungs, causing them to hyperinflate. Answers C and D are common in those with emphysema but do not cause the chest to become barrel shaped. Answer A does not occur in emphysema.

Question 2 of 5

An adult is admitted to the hospital with several days of vomiting and diarrhea. Admitting data show RBC level of 4.2 million/mm³ and hematocrit of 54%. What is the best interpretation of these data?

Correct Answer: B

Rationale: Elevated hematocrit (normal: 36-46% for females, 41-53% for males) with normal RBC suggests hemoconcentration from dehydration due to fluid loss from vomiting and diarrhea.

Question 3 of 5

Which comment by the client is most significant in light of the fact that he has Ménière's disease?

Correct Answer: C

Rationale: Cigarette smoking has been shown to aggravate Ménière's disease. The client will be told to stop smoking to decrease the frequency and severity of Ménière's. Walking, listening to an IPOD or other electronic device, and exposure to noise have not been shown to be related to Ménière's disease.

Question 4 of 5

Which of the following instructions would not be included in the discharge teaching for a client receiving Thorazine (chlorpromazine)?

Correct Answer: B

Rationale: Avoiding aged cheese is relevant for MAOIs, not chlorpromazine. Protective clothing prevents photosensitivity, hard candy relieves dry mouth, and reporting a sore throat is critical for agranulocytosis.

Question 5 of 5

The nurse is caring for a newborn 12 hours after an uncomplicated vaginal birth at 39 weeks gestation. Which of the following findings would require follow up? Select all that apply.

Correct Answer: B,D

Rationale: Yellowish skin suggests jaundice, which requires monitoring for bilirubin levels. An umbilical cord with one artery (instead of two) and one vein may indicate congenital anomalies, needing further evaluation. Plantar creases are normal at 39 weeks, the Babinski reflex (toes fanning) is expected, and gum cysts (Epstein pearls) are benign.

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