Nursing Elites

1. The medical record for a client states that the client has hemiplegia. What does this mean?

• A. The client can use his right arm, left leg, and left arm.
• B. The client has paralysis of all four extremities.
• C. The client has decreased vision in one eye.
• D. The client has paralysis on one side of the body.

Correct answer: D

Rationale: Hemiplegia refers to paralysis on one side of the body, affecting either the right or left side. Choice A is incorrect because it describes selective paralysis of specific limbs, not one side of the body. Choice B is incorrect as hemiplegia does not involve paralysis of all four extremities. Choice C is also incorrect as decreased vision in one eye is not indicative of hemiplegia.

2. A nurse enters the hospital room of a client with reduced immunity. What observation requires further action by the nurse?

• A. The client is in a private room.
• B. The client has a vase of fresh flowers on the table
• C. The client has a dedicated vital signs machine
• D. There is hand sanitizer by the door

Correct answer: B

Rationale:

3. While completing a health history the client reports experiencing blurring of vision in both eyes without associated pain. What condition does the nurse suspect?

• A. Macular degeneration
• B. Cataract
• C. Retinal detachment
• D. Glaucoma

Correct answer: B

Rationale: Cataracts can cause blurring of vision in both eyes without associated pain.

4. What activities should the client avoid after cataract surgery? (Select all that apply)

• A. Blowing one’s nose
• B. Bearing down during defecation
• C. Lifting items heavier than 10 pounds
• D. All of the Above

Correct answer: D

Rationale: After cataract surgery, the client should avoid activities that can increase intraocular pressure. Blowing one’s nose and bearing down during defecation can raise the pressure inside the eye, which can be harmful during the healing process. Lifting items heavier than 10 pounds can also lead to an increase in intraocular pressure. Therefore, all the activities mentioned in the choices (nose blowing, bearing down during defecation, and lifting heavy items) should be avoided after cataract surgery to promote proper healing and reduce the risk of complications.

5. A client recently had an above the knee amputation and complains of pain distal to the amputation. What type of pain is the client experiencing?

• A. Nociceptive
• B. Neuropathic
• C. Visceral
• D. Cutaneous

Correct answer: A

Rationale:

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