- (Topic 1)
The most commonly known vectors of Lyme disease are:

1. A. Mites
2. B. Fleas
3. C. Ticks
4. D. Mosquitoes

Correct Answer: C
(A) Mites are not the common vector of Lyme disease. (B) Fleas are not the common vector of Lyme disease. (C) Ticks are the common vector of Lyme disease. (D) Mosquitoes are not the common vector of Lyme disease.

- (Topic 4)
The nurse begins morning assessment on a male client and notices that she is unable to palpate either of his dorsalis pedis pulses in his feet. What is the first nursing action after assessing this finding?

1. A. Palpate these pulses again in 15 minutes.
2. B. Use a Doppler to determine presence and strength of these pulses.
3. C. Document the finding that the pulses are not palpable.
4. D. Call the physician and notify the physician of this finding.

Correct Answer: B
(A) Palpating these pulses again in 15 minutes may only result in the same findings. (B) Any time during an assessment that the nurse is unable to palpate pulses, the nurse should then obtain a Doppler and assess for presence or absence of the pulse and pulse strength, if a pulse is present. (C) Pulses may be present and assessed through use of a Doppler. Absence of palpable pulses does not indicate absence of blood flow unless pulses cannot be located with a Doppler. (D) The nurse would only call the physician after determining that the pulses are absent by both palpation and Doppler.

- (Topic 7)
Three hours postoperatively, a 27-year-old client complains of right leg pain after knee reduction. The first action by the nurse will be to:

1. A. Assess vital signs
2. B. Elevate the extremity
3. C. Perform a lower extremity neurovascular check
4. D. Remind the client that he has a client-controlled analgesic pump, and reinstruct him on its use

Correct Answer: C
(A) Vital signs may be altered if there is acute pain or complications related to bleeding or swelling, but they should not be assessed before checking the affected extremity. (B) The extremity will be elevated if ordered by the doctor. (C) Assessment of the postoperative area is important to determine if bleeding, swelling, or decreased circulation is occurring.
(D) Reinforcement of teaching on use of the client-controlled analgesic pump is important, but not the first action.

- (Topic 5)
A female client is anticipating a visit with her parents over the Thanksgiving holidays. She has recently begun experiencing periods of extreme shortness of breath, which her physician has labeled as panic attacks. Which of the following statements by the nurse would enhance therapeutic communication?

1. A. ??Why do you feel this way???
2. B. ??Tell me about your dislike for your parents.??
3. C. ??Don??t worry, everything will be all right on your visit with your parents.??
4. D. ??Perhaps you and I can discover what produces your anxiety.??

Correct Answer: D
(A) Asking the client to provide an explanation for her feelings is often intimidating. (B) This response is probing and may make the client feel used and valued only for the information she can provide. (C) This underrates the client??s feelings and belittles her concerns. It may cause the client to stop sharing feelings for fear that they will be ridiculed. (D) The emphasis is on working with the client. It shows that there is hope for change through collaboration.

- (Topic 4)
A 55-year-old client is admitted with a diagnosis of renal calculi. He presented with severe right flank pain, nausea, and vomiting. The most important nursing action for him at this time is:

1. A. Intake and output measurement
2. B. Daily weights
3. C. Straining of all urine
4. D. Administration of O2 therapy

Correct Answer: C
(A) Intake and output measurements are important but must be accompanied by straining urine. (B) Daily weights would not provide for identification of calculi. (C) Straining urine provides for assessment of calculi and evaluation of calculi descent through ureters and urethra. (D) O2therapy should not be necessary for renal calculi.