Extract:

Question 1 of 5

During the previous few months, a 56-year-old woman felt brief twinges of chest pain while working in her garden and has had frequent episodes of indigestion. She comes to the hospital after experiencing severe anterior chest pain while raking leaves. Her evaluation confirms a diagnosis of stable angina pectoris. After stabilization and treatment, the client is discharged from the hospital. At her follow-up appointment, she is discouraged because she is experiencing pain with increasing frequency. She states that she visits an invalid friend twice a week and now cannot walk up the second flight of steps to the friend's apartment without pain. Which of the following measures that the nurse could suggest would most likely help the client prevent this problem?

Correct Answer: C

Rationale: Taking sublingual nitroglycerin before exertion (e.g., climbing stairs) prevents angina by dilating coronary arteries, increasing myocardial oxygen supply.

Question 2 of 5

On the fourth day after surgery, a client has a postoperative wound infection. Which of the following should the nurse assess? Select all that apply.

A. Total white blood count (WBC) 10,000/mm³. B. Redness and swelling beyond the incision line. C. Temperature of 102°F (38.9°C). D. Client reports of pain at the incision site. E. Warmth at the incision site.

Correct Answer: B,C,D,E

Rationale: Signs of wound infection include redness/swelling (
B), fever (
C), pain (
D), and warmth (E). A WBC of 10,000/mm³ (
A) is normal and not indicative of infection.

Question 3 of 5

When beginning I.V. erythropoietin (Epogen, Procrit) therapy, the nurse should do which of the following? Select all that apply.

A. Checking the hemoglobin levels before administering subsequent doses. B. Shaking the vial thoroughly to mix the concentrated white, milky solution. C. Keeping the multidose vial refrigerated between scheduled twice-a-day doses. D. Administering the medication through the I.V. line without other medications. E. Adjusting the initial doses according to the client's changes in blood pressure. F. Educating the client to avoid driving and performing hazardous activity during the initial treatment.

Correct Answer: A,C,D,F

Rationale: For IV erythropoietin therapy, the nurse should check hemoglobin levels to monitor response and prevent overcorrection, keep multidose vials refrigerated to maintain stability, administer without mixing with other medications to avoid interactions, and educate about avoiding hazardous activities due to potential side effects like dizziness. Shaking the vial can denature the protein, and dose adjustments are typically based on hematologic response, not blood pressure.

Question 4 of 5

The client in balanced suspension traction is transported to surgery for closed reduction and internal fixation of his fractured femur. Which of the following should the nurse do when transporting the client to the operating room?

A. Transfer the client to a cart with manually suspended traction. B. Call the surgeon to request an order to temporarily remove the traction. C. Send the client on his bed with extra help to stabilize the traction. D. Remove the traction and send the client on a cart.

Correct Answer: C

Rationale: Transporting on the bed with extra help maintains traction stability, preventing fracture displacement.

Question 5 of 5

Which of the following guidelines reflects the current American Cancer Society recommendations for screening for colon cancer in individuals who are not at high risk?

A. Annual digital rectal examination should begin at age 40. B. Annual fecal testing for occult blood should begin at age 50. C. Individuals should obtain a baseline barium enema at age 40. D. Individuals should obtain a baseline colonoscopy at age 45.

Correct Answer: B

Rationale: Annual fecal testing for occult blood should begin at age 50. Annual digital rectal examinations are recommended in men beginning at age 50 to screen for prostate cancer. Baseline barium enemas or colonoscopies are recommended at age 50. Baseline barium enemas and colonoscopies are not performed on individuals in their 40s unless they recommend the nurse to the need for such diagnostic testing, or are considered to be at high risk. CN: Health promotion and maintenance; CL: Apply