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1. The nurse is planning care for a client admitted with a diagnosis of pheochromocytoma. Which intervention has the highest priority for inclusion in this client’s plan of care?
- A. Record urine output every hour
- B. Monitor blood pressure frequently
- C. Evaluate neurological status
- D. Maintain seizure precautions
Correct answer: B
Rationale: Pheochromocytoma is associated with severe hypertension due to excessive catecholamine release. Monitoring blood pressure frequently is the priority intervention to assess for hypertensive crises and prevent complications like stroke, heart attack, or organ damage. While recording urine output every hour, evaluating neurological status, and maintaining seizure precautions are important aspects of care, they are not the highest priority in a client with pheochromocytoma.
2. A female client with breast cancer who completed her first chemotherapy treatment today at an outpatient center is preparing for discharge. Which behavior indicates that the client understands her care needs?
- A. Rented movies and borrowed books to use while passing time at home
- B. Discussing dietary restrictions with the nurse
- C. Arranging follow-up appointments with her oncologist
- D. Reporting to the nurse any new or worsening symptoms
Correct answer: D
Rationale: The correct answer is D because reporting any new or worsening symptoms to the nurse is crucial for the early detection of potential complications. This behavior shows that the client understands the importance of monitoring her health status post-chemotherapy treatment. Choices A, B, and C are incorrect because while renting movies, borrowing books, discussing dietary restrictions, and arranging follow-up appointments are all important aspects of care, the most critical factor immediately after chemotherapy is to monitor and report any new or worsening symptoms to healthcare providers.
3. A client with eczema is experiencing severe pruritus. Which PRN prescription should the nurse administer?
- A. Topical corticosteroid
- B. Topical scabicide
- C. Topical alcohol rub
- D. Transdermal analgesic
Correct answer: A
Rationale: The correct answer is A: Topical corticosteroid. Topical corticosteroids are commonly used to manage itching in eczema by reducing inflammation and suppressing the immune response. In this case, for severe pruritus in eczema, a topical corticosteroid would be appropriate. Choice B, Topical scabicide, is used to treat scabies, not eczema. Choice C, Topical alcohol rub, is not typically used to manage pruritus in eczema. Choice D, Transdermal analgesic, is more for pain relief and not specifically targeted at managing itching associated with eczema.
4. Several clients on a busy antepartum unit are scheduled for procedures that require informed consent. Which situation should the nurse explore further before witnessing the client's signature on the consent form?
- A. The client was medicated for pain with a narcotic analgesic IM 6 hours ago
- B. A 15-year-old primigravida who has been self-supporting for the past 6 months
- C. The obstetrician explained a procedure that a neurologist will perform
- D. The client is illiterate but verbalizes understanding and consent for the procedure
Correct answer: D
Rationale: The correct answer is D because an illiterate client may require additional support to ensure they fully comprehend the information provided in the informed consent process. It is crucial to confirm that the client truly understands the nature of the procedure, its risks, and benefits. While it is important to assess pain control (choice A), a client's previous medication administration does not directly impact their ability to understand the consent process. Choice B, a 15-year-old primigravida who has been self-supporting, may legally provide informed consent depending on the jurisdiction and circumstances, so this situation may not require further exploration. Choice C, explaining a procedure by a different specialist, does not necessarily require additional exploration before witnessing the client's consent.
5. Which assessment is most important for the nurse to perform before ambulating a client with a history of syncope?
- A. Pedal pulses
- B. Breath sounds
- C. Oxygen saturation
- D. Blood pressure
Correct answer: D
Rationale: The correct answer is 'D: Blood pressure.' It is crucial to check the client's blood pressure before ambulating them, especially if they have a history of syncope. Monitoring blood pressure helps to prevent falls by ensuring that the client's blood pressure is stable enough to tolerate the activity. Choices A, B, and C are not as critical in this scenario. Checking pedal pulses, breath sounds, or oxygen saturation is important but not as crucial as assessing blood pressure when preparing to ambulate a client with a history of syncope.
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