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1. The healthcare provider is unable to palpate the client's left pedal pulses. Which of the following actions should the healthcare provider take next?
- A. Auscultate the pulses with a stethoscope.
- B. Call the physician.
- C. Use a Doppler ultrasound device.
- D. Inspect the lower left extremity.
Correct answer: C
Rationale: When pedal pulses are not palpable, using a Doppler ultrasound device is the appropriate next step to locate the pulse. Auscultating the pulses with a stethoscope (Choice A) is used for assessing blood flow in arteries above the clavicle, not for pedal pulses. Calling the physician (Choice B) may be necessary at a later stage, but initially, using a Doppler ultrasound device to locate the pulse is more appropriate. Inspecting the lower left extremity (Choice D) can provide visual information but will not help in locating the pedal pulses, making it a less suitable option.
2. The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this diagnosis?
- A. Frequent use of chewable and liquid antacids for indigestion
- B. Severe abdominal cramps and diarrhea after eating spicy foods
- C. Upper mid-abdominal gnawing and burning pain
- D. Marked weight loss and appetite over the last 3 to 4 months
Correct answer: C
Rationale: The correct answer is C: 'Upper mid-abdominal gnawing and burning pain.' This symptom is a classic presentation of peptic ulcer disease. Antacids (choice A) may provide relief but do not confirm the diagnosis. Severe abdominal cramps and diarrhea (choice B) are more suggestive of other conditions like irritable bowel syndrome. Weight loss and appetite changes (choice D) are non-specific and could be related to various health issues.
3. Which of the following conditions is most commonly associated with a high risk of stroke?
- A. Hypertension.
- B. Diabetes.
- C. Obesity.
- D. Smoking.
Correct answer: A
Rationale: Hypertension is the correct answer. Hypertension, also known as high blood pressure, is a major risk factor for stroke because it puts increased pressure on blood vessels in the brain, making them more prone to damage and increasing the likelihood of a stroke. While diabetes, obesity, and smoking are also risk factors for stroke, hypertension is the most commonly associated condition with a high risk of stroke due to its direct impact on the blood vessels.
4. What is an expected outcome when a client is receiving an IV administration of furosemide?
- A. Increased blood pressure.
- B. Increased urine output.
- C. Decreased pain.
- D. Decreased premature ventricular contractions.
Correct answer: B
Rationale: The correct answer is B: Increased urine output. Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle in the kidneys, leading to increased urine production. This diuretic effect helps to reduce fluid volume in the body, making it an expected outcome when a client is receiving furosemide. Choice A, increased blood pressure, is incorrect because furosemide typically causes a decrease in blood pressure due to its diuretic effect. Choice C, decreased pain, and choice D, decreased premature ventricular contractions, are unrelated to the pharmacological action of furosemide.
5. A client is scheduled for a barium swallow (esophagography) in 2 days. The nurse, providing preprocedure instructions, should tell the client to:
- A. Eat a regular supper and breakfast
- B. Remove all metal and jewelry before the test
- C. Expect diarrhea for a few days after the procedure
- D. Take all oral medications as scheduled with milk on the day of the test
Correct answer: B
Rationale: The correct answer is B: 'Remove all metal and jewelry before the test.' Before a barium swallow procedure, the client should fast for 8 to 12 hours to ensure the stomach and intestines are empty for optimal visualization. Removing all metal and jewelry is essential to prevent any interference with x-ray imaging. Choice A is incorrect because the client should fast, not eat supper and breakfast, before the test. Choice C is incorrect as diarrhea is not an expected outcome of a barium swallow. Choice D is incorrect as the client should not take any oral medications with milk on the day of the test to ensure accurate test results.
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