Attaching a restraint to a side rail or other movable part of the bed can:
Correct Answer: B
Attaching a restraint to a movable part of the bed can cause client injury if that part of the bed is moved before releasing restraints.Safety and Infection Control
Question 27
The PN is caring for a patient taking Lipitor (Atorvastatin). Which of these statements would indicate that the patient may need reinforced teaching?
Correct Answer: A
Section: Physiological Integrity
Question 28
Which of the following statements is true about syphilis?
Correct Answer: D
Syphilis is an acute and chronic treponemal disease characterized clinically by a primary lesion, a secondary eruption involving skin and mucous membranes, long periods of latency, and late lesions of skin, bone viscera, the CNS, and the cardiovascular system. The primary lesion (chancre) appears about three weeks after exposure as an indurated, painless ulcer with serous exudate at the site of initial invasion. Invasion of the bloodstream precedes development of the initial lesion, and a firm, nonfluctuant, painless lymph node (bubo) commonly follows. Infection might occur without a clinically evident chancre; that is, it might be in the rectum or on the cervix. After four-six weeks, even without specific treatment, the chancre begins to involute, and, in approximately one-third of untreated cases, a generalized secondary eruption appears, often accompanied by mild constitutional symptoms. This symmetrical maculopapular rash involving the palms and soles, with associated lymphadenopathy is classic. Secondary manifestations resolve spontaneously within weeks to 12 months. Again, about one-third of untreated cases of secondary syphilis become clinically latent for weeks to years. In the early years of latency, infectious lesions of the skin and mucous membranes might recur. Specific treatment includes long-acting penicillin G (benzathine penicillin), 2.4 million units given in a single IM dose on the day that primary, secondary or early latent syphilis is diagnosed. This ensures effective therapy, even if the client fails to return. Serologic testing is important to ensure adequate therapy. Tests are repeated three and six months after treatment and later as needed. In HIV-infected clients, testing should be repeated one, two, and three months after treatment, and at three-month intervals thereafter. Any fourfold titer rise indicates the need for retreatment.Physiological Adaptation
Question 29
A hospitalized adult client who routinely works from midnight until 8 a.m. has a temperature of 99.1° F at 4 a.m. The nurse determines that this is most likely due to:
Correct Answer: D
Explanation/Reference: Explanation: Biological rhythms that follow a cycle lasting about 24 hours are termed circadian rhythm. The sleep-wake cycle is closely linked with cardiac rhythms, such as body temperature. While a person sleeps, core body temperature drops, often reaching the 24-hour low at 4 a.m. When the sleep period shifts, temperature fluctuations also shift to match the new sleep patterns. Basic Care and Comfort
Question 30
The intravenous route is potentially the most dangerous route of drug administration because __________.
Correct Answer: C
Section: Physiological Integrity Explanation: The bioavailability of the injected medication is 100% and might lead to toxicity. An IV infiltration can cause serious problems with tissue necrosis, but this is not life threatening. Expensive and time consuming do not equate with dangerous. Choice "the client always has more side effects" is not always true.
