Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions?
A. Ambulating soon after surgery.
Ambulating soon after surgery is actually encouraged as it promotes blood flow and reduces the risk of VTE.
B. Massaging her legs.
Massaging the legs can dislodge a clot if one has formed, leading to a VTE.
C. Flexing her ankles.
Flexing the ankles promotes blood flow and reduces the risk of VTE.
D. Elevating her feet.
Elevating the feet can reduce swelling and promote venous return, reducing the risk of VTE.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Med Surg Custom Proctored Exam 2. Take the full exam now
Full Explanation
Choice A rationale:
Ambulating soon after surgery is actually encouraged as it promotes blood flow and reduces the risk of VTE.
Choice B rationale:
Massaging the legs can dislodge a clot if one has formed, leading to a VTE.
Choice C rationale:
Flexing the ankles promotes blood flow and reduces the risk of VTE.
Choice D rationale:
Elevating the feet can reduce swelling and promote venous return, reducing the risk of VTE.
Similar Questions
A nurse is caring for a client following cataract surgery. Which of the following comments from the client should the nurse report to the client's provider?
A. "The bright light in this room is really bothering me.”.
Sensitivity to light is a common postoperative symptom after cataract surgery.
B. "It's hard to see with a patch on one eye. I'm afraid of falling.”.
Difficulty with depth perception is expected when one eye is patched.
C. "I need something for the pain in my eye. I can't stand it.”.
Severe pain is not a normal postoperative symptom and should be reported to the provider.
D. "My eye really itches, but I'm trying not to rub it.”.
Itching is a common postoperative symptom after cataract surgery.
Full Explanation
Choice A rationale:
Sensitivity to light is a common postoperative symptom after cataract surgery.
Choice B rationale:
Difficulty with depth perception is expected when one eye is patched.
Choice C rationale:
Severe pain is not a normal postoperative symptom and should be reported to the provider.
Choice D rationale:
Itching is a common postoperative symptom after cataract surgery.
A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department.
The client is confused, flushed, and with an acetone odor on the breath.
Diabetic ketoacidosis is suspected.
The nurse should anticipate using which of the following types of insulin to treat this client?
A. Insulin glargine.
Insulin glargine is a long-acting insulin and is not used for the immediate treatment of diabetic ketoacidosis (DKA).
B. Insulin detemir.
Insulin detemir is also a long-acting insulin and is not used for the immediate treatment of DKA.
C. Regular insulin.
Regular insulin is a short-acting insulin and is used for the immediate treatment of DKA.
D. NPH insulin.
NPH insulin is an intermediate-acting insulin and is not used for the immediate treatment of DKA.
Full Explanation
Choice A rationale:
Insulin glargine is a long-acting insulin and is not used for the immediate treatment of diabetic ketoacidosis (DKA).
Choice B rationale:
Insulin detemir is also a long-acting insulin and is not used for the immediate treatment of DKA.
Choice C rationale:
Regular insulin is a short-acting insulin and is used for the immediate treatment of DKA.
Choice D rationale:
NPH insulin is an intermediate-acting insulin and is not used for the immediate treatment of DKA.
A nurse is teaching with a group of nurses about the administration of nitroglycerin. Which of the following routes of administration provides the most rapid onset for the client?
A. Sublingual.
Sublingual administration of nitroglycerin provides the most rapid onset. This route allows the medication to be absorbed directly into the bloodstream through the mucous membranes under the tongue, bypassing the digestive system.
B. Suspended-release.
Sustained-release nitroglycerin is designed to be released slowly over time. This form of the drug does not provide rapid relief of acute angina symptoms.
C. Transdermal patch.
Transdermal patches of nitroglycerin provide a slow, continuous dose of medication. This is beneficial for long-term management of angina, but it does not provide rapid relief.
D. Topical ointment.
Topical ointments also provide a slow, continuous dose of medication and are not intended for rapid relief of acute symptoms.
Full Explanation
Choice A rationale:
Sublingual administration of nitroglycerin provides the most rapid onset. This route allows the medication to be absorbed directly into the bloodstream through the mucous membranes under the tongue, bypassing the digestive system.
Choice B rationale:
Sustained-release nitroglycerin is designed to be released slowly over time. This form of the drug does not provide rapid relief of acute angina symptoms.
Choice C rationale:
Transdermal patches of nitroglycerin provide a slow, continuous dose of medication. This is beneficial for long-term management of angina, but it does not provide rapid relief.
Choice D rationale:
Topical ointments also provide a slow, continuous dose of medication and are not intended for rapid relief of acute symptoms.