To prevent fungal infections of the mouth and throat, the nurse should teach clients on inhaled steroids to:
A. Rinse the plastic holder that aerosolizes the drug with hydrogen peroxide every other day
B. Rinse the mouth and gargle with warm water after each use of the inhaler
C. Take antacids immediately before inhalation to neutralize mucous membranes and prevent infection
D. Rinse the mouth before each use to eliminate colonization of bacteria
Which type of insulin can be administered by a continuous IV drip?
A. Humulin N
B. NPH insulin
C. Regular insulin
D. Lente insulin
A client has been admitted to the labor and delivery unit in active labor. After assessing her, the RN notes that the client's fetus position is left occipital posterior. Which of the following statements best describes what this means to the labor process:
A. Decreases the overall time of the labor process
B. Prolongs the client's first stage of labor
C. Decreases the time of the client's first stage of labor
D. Prolongs the client's third stage of labor
A 68-year-old client developed acute respiratory distress syndrome while hospitalized for pneumonia. After a respiratory arrest, an endotracheal tube was inserted. Several days later, numerous attempts to wean him from mechanical ventilation were ineffective, and a tracheostomy was created. For the first 24 hours following tracheostomy, it is important to minimize bleeding around the insertion site. The nurse can accomplish this by:
A. Deflating the cuff for 10 minutes every other hour instead of 5 minutes every hour
B. Avoiding manipulation of the tracheostomy including cuff deflation
C. Reporting any signs of crepitus immediately to the physician
D. Changing tracheostomy dressing only as necessary using one-half strength hydrogen peroxide to cleanse the site
A client sustained second- and third-degree burns to his face, neck, and upper chest. Which of the following nursing diagnoses would be given the highest priority in the first 8 hours' postburn?
A. Fluid volume deficit secondary to alteration in skin integrity
B. Alteration in comfort secondary to alteration in skin integrity
C. Alteration in sensation secondary to third-degree burn
D. Alteration in airway integrity secondary to edema of neck and face, which in turn is secondary to alteration in skin integrity
A 52-year-old client is scheduled for a small-bowel resection in the morning. In conjunction with other preoperative preparation, the nurse is teaching her diaphragmatic breathing exercises. She will teach the client to:
A. Inhale slowly and deeply through the nose until the lungs are fully expanded, hold the breath a couple of seconds, and then exhale slowly through the mouth. Repeat 2? more times to complete the series every 1? hours while awake
B. Purse the lips and take quick, short breaths approximately 18?0 times/min
C. Take a large gulp of air into the mouth, hold it for 10?5 seconds, and then expel it through the nose. Repeat 4? times to complete the series
D. Inhale as deeply as possible and then immediately exhale as deeply as possible at a rate of approximately 20?4 times/min
A female client has married recently. A month ago she visited her physician with complaints of burning on urination. She was given a prescription for trimethoprim- sulfamethoxazole (Bactrim) DS bid for 10 days. She was admitted through the emergency room on Saturday evening complaining of flank pain. Her temperature was 104_F. A preliminary urinalysis revealed 31 bacteria along with red and white blood cells in the urine. A preliminary diagnosis of pyelonephritis was made. During a nursing admission assessment, which statement by the client demonstrates a possible cause for pyelonephritis?
A. "I have not been drinking six to eight glasses of water each day as the nurse had instructed."
B. "I'm afraid I may have something wrong with my bladder because I have been getting bladder infections frequently since I've been married."
C. "I took the Bactrim for 6 or 7 days. The burning stopped, so I saved the rest of the medication for the next time."
D. "I recently had the flu, which could be settling in my kidneys now."
A 49-year-old obese woman has been admitted to the general surgery unit with choledocholithiasis. As the nurse is admitting her to the unit, she states, "The doctor said I have stones that need to be removed; where are they?" The nurse knows that the best explanation for this is to tell her that:
A. There are stones present in her gallbladder
B. There are stones present in her kidneys
C. There are stones present in her common bile duct
D. There are no stones, but her gallbladder is irritated and caused her nausea, vomiting, and pain
A 12-year-old girl has been diagnosed with insulindependent diabetes mellitus. Which of these principles would best guide her nutritional management?
A. Concentrated sweets are taken during increased activity.
B. Food restriction is imposed to reduce weight.
C. Caloric distribution should be calculated to fit activity patterns.
D. Fat requirements are increased owing to the possibility of ketoacidosis.
An 80-year-old male client with a history of arteriosclerosis is experiencing severe pain in his left leg that started approximately 20 minutes ago. When performing the admission assessment, the nurse would expect to observe which of the following:
A. Both lower extremities warm to touch with 2_pedal pulses
B. Both lower extremities cyanotic when placed in a dependent position
C. Decreased or absent pedal pulse in the left leg
D. The left leg warmer to touch than the right leg
