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1. When a client with dementia frequently becomes agitated, what should the nurse prioritize investigating?
- A. Fluid and electrolyte imbalances
- B. Medication history
- C. Environmental factors
- D. Cognitive functioning
Correct answer: B
Rationale: The correct answer is to prioritize investigating the client's medication history. This is important because certain medications can contribute to agitation in clients with dementia. Understanding the medication history can help identify potential causes of agitation and guide appropriate interventions. Checking for fluid and electrolyte imbalances is important in healthcare but may not directly relate to the client's agitation. While environmental factors can influence behavior, investigating the medication history is more pertinent in this case. Cognitive functioning assessment is crucial in dementia care but may not be the priority when addressing acute agitation.
2. How should a healthcare professional assess a patient with suspected deep vein thrombosis (DVT)?
- A. Monitor for leg pain, swelling, and redness
- B. Check for calf tenderness and administer anticoagulants
- C. Check for discoloration and monitor oxygen saturation
- D. Check for numbness and provide thrombolytic therapy
Correct answer: A
Rationale: Correct Answer: The correct way to assess a patient with suspected deep vein thrombosis (DVT) is to monitor for leg pain, swelling, and redness. These are common clinical manifestations of DVT. Choice B is incorrect because administering anticoagulants should be based on a confirmed diagnosis, not just suspicion. Choice C is incorrect because discoloration and oxygen saturation are not primary indicators of DVT. Choice D is incorrect because numbness is not a typical symptom of DVT, and thrombolytic therapy is not the first-line treatment for suspected DVT.
3. A client scheduled to begin chemotherapy is discussing alopecia with a nurse. Which of the following statements should the nurse make?
- A. Avoid washing your hair during treatment
- B. Your oncologist might prescribe a cold cap during treatment to reduce hair loss
- C. You'll need to apply sunscreen to the scalp
- D. You'll likely experience regrowth of hair within 6 months after treatment ends
Correct answer: B
Rationale: The correct answer is B. The nurse should inform the client that their oncologist might prescribe a cold cap during treatment to reduce chemotherapy-induced hair loss by cooling the scalp. Choice A is incorrect as washing the hair during treatment is generally recommended. Choice C is incorrect as sunscreen is not typically needed for the scalp in this context. Choice D is incorrect as regrowth of hair can vary among individuals and is not guaranteed within a specific timeframe.
4. When caring for a client diagnosed with delirium, what condition should the nurse prioritize investigating?
- A. Investigate medication history
- B. Investigate sensory deficits
- C. Investigate cognitive functioning
- D. Investigate for signs of infection
Correct answer: D
Rationale: The correct answer is to investigate for signs of infection when caring for a client diagnosed with delirium. Infections can frequently cause or worsen delirium. While investigating medication history, sensory deficits, and cognitive functioning may be important in the overall care of the client, when prioritizing, the nurse should first rule out or address potential infections due to their significant impact on delirium.
5. A nurse is teaching a client who has irritable bowel syndrome (IBS) about dietary modifications. Which of the following instructions should the nurse include?
- A. Increase fiber intake to 35 grams per day
- B. Avoid dairy products
- C. Eat small, frequent meals
- D. Avoid fruits and vegetables
Correct answer: C
Rationale: The correct answer is C: 'Eat small, frequent meals.' Eating small, frequent meals helps manage IBS symptoms by avoiding overloading the digestive system. Choice A is incorrect because increasing fiber intake may worsen symptoms in some individuals with IBS. Choice B is not a blanket recommendation for all IBS patients; some may tolerate dairy products well. Choice D is incorrect as fruits and vegetables are important sources of nutrients and should not be completely avoided unless specific triggers are identified.
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