A client with a diagnosis of deep vein thrombosis (DVT) is receiving anticoagulant therapy. Which instruction should the nurse provide to the client?

Correct Answer: B

Rationale: In this scenario, the correct instruction for a client with DVT receiving anticoagulant therapy is to report any signs of bleeding to the healthcare provider (Option B). This instruction is crucial because anticoagulants increase the risk of bleeding, so early detection and management of any bleeding are essential to prevent complications. Option A is incorrect because walking is actually encouraged in DVT to prevent stasis and further clot formation. Option C is incorrect because aspirin is not recommended for pain relief in this case as it can increase the risk of bleeding due to its antiplatelet effects. Option D is also incorrect as compression stockings are typically worn during the day to promote venous return and reduce swelling, not at night. Educationally, understanding the rationale behind the correct answer reinforces the importance of patient safety and monitoring for adverse effects of medications. It also highlights the critical role of nurses in patient education to ensure optimal outcomes in the management of DVT and anticoagulant therapy. By providing accurate information, nurses empower patients to actively participate in their care and promote their overall well-being.

Correct Answer: A

Rationale: The correct answer is A, Vastus Lateralis. The vastus lateralis site is recommended for IM injections in small children due to its large muscle mass, making it suitable for injections in pediatric patients. Choices B, C, and D are incorrect. The radial artery is not a site for IM injections; it is a site for arterial puncture. The dorsogluteal site is not recommended for children due to potential risks, such as injury to the sciatic nerve. The rectus femoris is not typically used for IM injections in children, as other sites like the vastus lateralis are more commonly preferred.

Correct Answer: D

Rationale: A glucose level of 50 mg/dL is indicative of hypoglycemia, which requires immediate intervention to prevent further complications. Hypoglycemia can lead to serious consequences such as altered mental status, seizures, and even coma if not promptly addressed. The other options do not present immediate life-threatening conditions that require urgent intervention. Shortness of breath with a hemoglobin of 8 grams may indicate anemia but does not require immediate intervention. Bleeding from a finger stick with a prothrombin time of 30 seconds may suggest clotting issues, which are important but not as immediately critical as hypoglycemia. Being febrile with an elevated WBC count could indicate infection, which is concerning but not as urgently critical as hypoglycemia.

Correct Answer: A

Rationale: The correct answer is A: To drain air and fluid from the pleural space. A chest tube is primarily used to remove accumulated air or fluid in the pleural space, preventing lung collapse or compromise of lung function. This intervention aims to re-expand the lung and enhance respiratory function. Choice B is incorrect because preventing infection is not the primary purpose of a chest tube. Choice C is incorrect as lung expansion is a result of draining the pleural space, not the primary goal. Choice D is incorrect as monitoring intrathoracic pressure is not the main objective of a chest tube insertion.

Correct Answer: C

Rationale: The correct instruction for the nurse to provide is to shake the inhaler before each use. Shaking the inhaler ensures proper mixing of the medication before administration, which is crucial for its effectiveness. Choice A is incorrect because albuterol inhalers are often used as a preventive measure, not just during asthma attacks. Choice B is a good practice to prevent oral fungal infections associated with inhaled corticosteroids, not typically with albuterol. Choice D is important for proper inhaler technique, but the primary step before inhaling is shaking the inhaler to ensure the medication is well mixed.