- (Topic 5)
A client has been instructed in how to take her nitroglycerin tablets. The nurse giving her instructions knows the client understands the information when she tells her:

1. A. ??I should contact my physician if I have headaches after I take this medicine.??
2. B. ??I should keep the tablets in the refrigerator.??
3. C. ??I should call the doctor if three doses of the medicine do not relieve my pain.??
4. D. ??I should take these with water but not with milk.??

Correct Answer: C
(A) Headaches may occur after taking nitroglycerin because of vasodilation. (B) The tablets do not need to be refrigerated. The client should carry them with her. (C) The client should contact the physician if repeated doses of nitroglycerin do not relieve the discomfort. (D) Nitroglycerin tablets should be dissolved under the tongue, not swallowed.

- (Topic 3)
A laboring client presents with a prolapsed cord. The nurse should immediately place the client in what position?

1. A. Reverse Trendelenburg
2. B. Fowler??s
3. C. Trendelenburg
4. D. Sims??

Correct Answer: C
(A) Reverse Trendelenburg position increases pressure on the perineum. This position will not relieve cord pressure. (B) Fowler??s position increases perineal pressure. Cord pressure would not be relieved. (C) Trendelenburg position will decrease perineal pressure. Cord compression will be decreased and increase in fetal blood flow occurs. (D) Sims?? position does not relieve pressure on cord or perineum.

- (Topic 4)
A postoperative prostatectomy client is preparing for discharge from the hospital the next morning. The nurse realizes that additional instructions are necessary when he states:

1. A. ??If I drink 10 to 12 glasses of fluids each day, that will help to prevent any clot formation in my urine.??
2. B. ??The isometric exercises will help to strengthen my perineal muscles and help me control my urine.??
3. C. ??If I feel as though I have developed a fever, I will take a rectal temperature, which is the most accurate.??
4. D. ??I do not plan to do any heavy lifting until I visit my doctor again.??

Correct Answer: C
(A) This is correct health teaching. Drinking 10–12 glasses of clear liquid will help increase
urine volumes and prevent clot formation. (B) This is correct health teaching. These types of exercises are prescribed by physicians to assist postprostatectomy clients to strengthen their perineal muscles. (C) This action is not recommended post-TURP because of the close proximity of the prostate and rectum. (D) This is correct healthcare teaching. The client should limit walking long distances, lifting heavy objects, or driving a car until these activities are cleared by the physician at the first office visit.

- (Topic 7)
The nurse is teaching a client how to perform monthly testicular self-examination (TSE) and states that it is best to perform the procedure right after showering. This statement is made by the nurse based on the knowledge that:

1. A. The client is more likely to remember to perform the TSE when in the nude
2. B. When the scrotum is exposed to cool temperatures, the testicles become large and bulky
3. C. The scrotum will be softer and more relaxed after a warm shower, making the testicles easier to palpate
4. D. The examination will be less painful at this time

Correct Answer: C
(A) Nudity is not a trigger for reminding males to perform TSE. (B) Testicles become more firm when exposed to cool temperatures, but not large and bulky. (C) The testicles will be lower and more easily palpated with warmer temperatures. A protective mechanism of the body to protect sperm production is for the scrotum to pull closer to the body when exposed to cooler temperatures. (D) The examination should not be painful.

- (Topic 5)
A 24-year-old graduate student recognizes that he has a phobia. He suffers severe anxiety when he is in darkness. It has altered his lifestyle because he is unable to go to a movie theater, concert, and other events that may require absence of light. The client is seeking assistance because he is no longer able to socialize with friends due to his phobia. The psychologist working with him is using desensitization. He has asked the nursing staff to assist the client in muscle relaxation techniques. What result would indicate client education has been successful?

1. A. He enters a movie theater, sits in his chair, and replaces anxiety with relaxation as the theater darkens.
2. B. He enters a concert, but as the lights dim, he does not experience anxiety.
3. C. He states that he no longer fears dark places.
4. D. He takes a part-time job as a photographic assistan
5. E. His job necessitates his working in a darkroom.

Correct Answer: A
(A) This situation provides specific evidence that the client is able to integrate muscle relaxation technique into his lifestyle to alleviate anxiety. (B) The client may not experience anxiety at the concert, but there is no evidence regarding the technique that he used to alleviate anxiety. (C) The client may state he no longer experiences anxiety, but there is no evidence demonstrating this. He may be denying anxiety to discontinue therapy prematurely. (D) Does he experience anxiety in the darkroom? He may have taken this job to force himself to deal with the phobia directly.