Adult Health Exam 1

Four days after the client's total hip arthroplasty, the nurse is preparing to transfer the client to a rehabilitation center. Before admission the client took warfarin sodium (Coumadin) daily for a history of pulmonary embolus. While hospitalized, the client received subcutaneous heparin two times a day. The nurse does not see any anticoagulant therapy listed on the client's transfer prescriptions. The nurse should: 1. contact the health care provider to determine what anticoagulant therapy should be prescribed for this client 2. arrange supply of heparin for the client to take to the rehab center 3. explain to the client that anticoagulant therapy will no longer be needed 4. instruct the client to talk about anticoagulant needs with the health care provider at the rehabilitation center

1

a client is on cardiac monitor. the monitor begins to alarm showing ventricular tachycardia. what should the nurse do first? 1. check for pulse 2. start cardiac compressions 3. prepare to defibrillate the client 4. administer 02 via an ambu bag

1

nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. the client asks the nurse how long it should take for the chest pain to subside after nitroglycerin is taken. what should the nurse tell the client? 1. 1-3 min 2. 4-5 sec 3. 30-45 sec 4. 20-45 min

1

which assessment should the nurse obtain before administering digoxin? 1. apical heart 2. radial pulse on the left side 3. radial pulse in both right and left arms 4. difference between apical and radial pulses

1

a nurse is caring for a child with newly diagnosed acute lymphoblastic leukemia. what clinical findings does the nurse anticipate when assessing the child? select all that apply 1. pallor 2. fatigue 3. jaundice 4. multiple bruises 5. generalized edema

124

a client with angina pectoris is scheduled for stress echocardiogram. what does the nurse explain echocardiogram is? 1. tool used solely to determine the cause of chest pain 2. noninvasive approach to assess cardiovascular status 3. modality of minimal value in planning treatment for angina 4. test that is invasive that measures the body's reaction to progressive increases in exertion

2

the nurse recalls that cbc is composed of several tests, one of which is the level of what? 1. blood glucose 2. hemoglobin 3. reactive protein 4. BUN

2

when assessing a client with heart failure, the nurse asks when the client most notices an increase in symptoms. which activity should the nurse expect will cause the client the greatest distress? 1. getting up from bed in the morning 2. walking to visit the next door neighbor 3. climbing a flight of stairs to the bedroom 4. leaving the table immediately after a meal

3

A client with a dysrhythmia is admitted to telemetry for observation. In the morning, the client asks for a cup of coffee. What is the nurse's best response? 1. hot drinks such as coffee are not good for your heart 2. coffee is not permitted on the diet prescribed for you 3. you cannot have coffee. i can bring you a cup of tea if you like 4. coffee has caffeine, which can affect your heart. it should be avoided

4

The day after surgery a client is encouraged to ambulate. The client angrily asks the nurse, "Why am I being made to walk so soon after surgery?" How should the nurse explain the primary purpose of early ambulation? 1. To promote healing of the incision2. To decrease the incidence of urinary tract infections3. To use energy to help the client sleep better at night4. To keep blood from pooling in the legs to prevent clots

4

a child with leukemia who is undergoing chemotherapy is susceptible to rectal ulcerations. what should the nurse recommend to the parents that will lessen the severity of this problem? 1. encourage lying on the abdomen when in bed 2. have the child wear cotton underpants at night 3. apply rectal ointment liberally 4 times a day 4. clean the child's perianal area after each bowel movement

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