A nurse is assessing a client who has myasthenia gravis. Which of the following client statements should indicate to the nurse that the client needs a referral for occupational therapy?

"I've been having problems with bladder control."

"I have difficulty swallowing food."

"I have a hard time with brushing my hair."

"I would rather be in a wheelchair than use a walker to get around."

Answer and Explanation

The Correct Answer is C

Choice A reason: While bladder control issues can significantly affect a client's quality of life, they are typically managed by a urologist or a specialist in continence, rather than an occupational therapist. Occupational therapy focuses on improving the ability to perform activities of daily living (ADLs), which generally does not include bladder control.

Choice B reason: Difficulty swallowing, known as dysphagia, can be a symptom of myasthenia gravis due to muscle weakness. Although it is a serious concern, it is usually managed with the help of a speech therapist who specializes in swallowing difficulties, rather than an occupational therapist.

Choice C reason: Having a hard time with brushing hair is directly related to the performance of ADLs, which is the primary focus of occupational therapy. An occupational therapist can assist the client by teaching energy conservation techniques, providing adaptive equipment, and modifying the task to make it easier for the client to maintain personal grooming independently.

Choice D reason: Preferring a wheelchair over a walker is a matter of mobility and personal preference. While occupational therapy can help with mobility issues, this statement alone does not indicate a need for occupational therapy unless the client has difficulty performing ADLs due to the choice of mobility aid.

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Correct Answer is C

Explanation

Choice A reason: A heart rate of 60/min is within the normal range for an adult, and while it may be considered on the lower end, it is not in itself an indication to increase dopamine dosage. Dopamine is used to increase heart rate and cardiac output, but a rate of 60/min does not typically warrant an increase in dosage unless accompanied by other signs of inadequate perfusion.

Choice B reason: An oxygen saturation of 95% is within the normal range for arterial blood gases and is not an indication to increase dopamine dosage. Oxygen saturation reflects the percentage of hemoglobin binding sites in the bloodstream occupied by oxygen.

Choice C reason: A blood pressure of 90/50 mm Hg is considered low and can be an indication for increasing the dopamine dosage in a client with hypovolemic shock. Dopamine increases blood pressure by vasoconstriction and increasing cardiac output, which is critical in managing shock.

Choice D reason: A respiratory rate of 14/min is within the normal range for adults and is not an indication to increase dopamine dosage. The respiratory rate should be monitored for changes that could indicate worsening of the client's condition, but on its own, it does not dictate adjustments to dopamine therapy.

A. Uric acid B. Intrinsic factor C. Chloride level D. Creatinine kinase

Correct Answer is A

Explanation

Choice A reason : Uric acid levels are expected to be increased in a client with acute gout. Gout is associated with hyperuricemia, where serum or plasma urate concentrations exceed 6.8 mg/dL. This elevation in uric acid can lead to the formation of monosodium urate crystals in joints, causing the characteristic painful inflammation of gout.

Choice B reason : Intrinsic factor is not related to gout. It is a protein produced by the stomach that is necessary for the absorption of vitamin B12.

Choice C reason : Chloride levels are typically not affected in acute gout and are not a specific indicator for this condition.

Choice D reason : Creatinine kinase is an enzyme found in the heart, brain, skeletal muscle, and other tissues. Elevated levels may indicate muscle damage but are not a specific marker for gout.

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A nurse is assessing a client who has myasthenia gravis. Which of the following client statements should indicate to the nurse that the client needs a referral for occupational therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?

Correct Answer is C

Explanation

A nurse is reviewing the medical record of a client who has acute gout. The nurse should expect an increase in which of the following laboratory results?

Correct Answer is A

Explanation

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