- (Topic 5)
A 78-year-old female client has a total hip arthroplasty. Her nurse should know that which of the following is contraindicated?

1. A. Encourage exercises in the unaffected extremities.
2. B. Encourage her to cross and uncross her legs.
3. C. Check neurological and circulatory status of the affected leg hourly.
4. D. Place a trochanter roll along the upper thigh of the affected leg.

Correct Answer: B
(A) Exercising the unaffected extremities will prevent contractures and emboli. (B) Crossing and uncrossing the affected leg after surgery can dislocate the joint. (C) Neurological and circulatory status of the affected leg has been compromised by surgery. Hourly checks are needed to monitor the status of the leg. (D) A trochanter roll will prevent the upper thigh from rolling outward, increasing the chances of dislocation.

- (Topic 2)
Which of the following changes in blood pressure readings should be of greatest concern to the nurse when assessing a prenatal client?

1. A. 130/88 to 144/92
2. B. 136/90 to 148/100
3. C. 150/96 to 160/104
4. D. 118/70 to 130/88

Correct Answer: D
(A, B, C) The individual??s systolic and diastolic changes are more significant than the relatively high initial blood pressure readings. (D) The systolic pressure went up 12 mm Hg and the diastolic pressure 18 mm Hg. This is a more significant rise than the increases in A–C choices, and client should receive more frequent evaluations and care.

- (Topic 7)
Which of the following physician??s orders would the nurse question on a client with chronic arterial insufficiency?

1. A. Neurovascular checks every 2 hours
2. B. Elevate legs on pillows
3. C. Arteriogram in the morning
4. D. No smoking

Correct Answer: B
(A) Neurovascular checks are a routine part of assessment with clients having this diagnosis. (B) Elevation of the legs is contraindicated because it reduces blood flow to areas already compromised. (C) Arteriogram is a routine diagnostic order. (D) Smoking is highly correlated with this disorder.

- (Topic 6)
A client??s record from the ED indicates that she overdosed on phenelzine sulfate (Nardil), a monoamine oxidase (MAO) inhibitor. Which diet would be the most appropriate at this time?

1. A. High carbohydrate, low cholesterol
2. B. High protein, high carbohydrate
3. C. 1 g sodium
4. D. Tyramine-free

Correct Answer: D
(A) There are no data to support the need for increased carbohydrates or decreased cholesterol in the diet. (B) There is no data to support the need for increased protein or increased carbohydrates in the diet. (C) There is no assessment or laboratory data indicating that sodium should be restricted in the diet. (D) Tyramine is an amino acid activated by MAO in the liver and intestinal wall. It is released as proteins are hydrolyzed through aging, pickling, smoking, or spoilage of foods. When MAO is inhibited, tyramine levels rise, stimulating the adrenergic system to release large amounts of norepinephrine, which can produce a hypertensive crisis.

- (Topic 4)
In the coronary care unit, a client has developed multifocal premature ventricular contractions. The nurse should anticipate the administration of:

1. A. Furosemide
2. B. Nitroglycerin
3. C. Lidocaine
4. D. Digoxin

Correct Answer: C
(A) Furosemide is a loop diuretic. (B) Nitroglycerin is a vasodilator. (C) Lidocaine is the drug of choice to treat ectopic ventricular beats. (D) Digoxin slows down the electrical impulses and increases ventricular contractions, but it does not rapidly correct ventricular ectopy.