A nurse is caring for a client who is postoperative following a right radical mastectomy. Which of the following actions should the nurse take to prevent the development of lymphedema?

Obtain blood pressure readings using the client's right arm.

Limit range-of-motion exercises with the affected arm.

Keep both arms below the level of the client's heart.

Use the client's left arm to obtain blood samples.

Answer and Explanation

The Correct Answer is D

The client had a right radical mastectomy, which can lead to lymphedema, a buildup of fluid that can cause swelling in the arm. Using the client's left arm to obtain blood samples can help prevent injury to the affected arm and reduce the risk of lymphedema. Obtaining blood pressure readings with the client's left arm is also recommended. Range-of-motion exercises are important to prevent stiffness, and elevating the affected arm can help reduce swelling.

A: Obtaining blood pressure readings with the client's right arm can cause injury and increase the risk of lymphedema.

B: Limiting range-of-motion exercises can lead to stiffness and may not prevent lymphedema.

C: Keeping both arms below the level of the client's heart can help reduce swelling, but does not directly prevent lymphedema.

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Correct Answer is A

Explanation

The nurse should include monitoring for muscle paralysis in the plan of care for a client with botulism poisoning. Botulism is a serious bacterial illness that can cause muscle paralysis and can be life threatening. Monitoring for muscle paralysis is essential for early detection and intervention.

Choice B is incorrect because contact isolation is not necessary for the treatment of botulism.

Choice C is incorrect because increased salivation is not a common symptom of botulism.

Choice D is incorrect because clindamycin hydrochloride is not used to treat botulism.

A. Take iron supplements between meals for maximum absorption. B. Reduce gastric distress by taking iron supplements with an antacid. C. Check for orange-colored stools after 4 days of treatment. D. Mix iron supplements with milk to prevent staining of the teeth.

Correct Answer is A

Explanation

The correct answer is choice A. The nurse should instruct the client to take iron supplements between meals for maximum absorption. Choice B is incorrect because antacids can decrease the absorption of iron. Choice C is incorrect because orange-colored stools may occur after the first dose of iron. Choice D is incorrect because milk can also decrease the absorption of iron. Choice B is not correct because antacids can decrease the absorption of iron. Choice C is not correct because orange-colored stools may occur after the first dose of iron. Choice D is not correct because milk can also decrease the absorption of iron.

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A nurse is caring for a client who is postoperative following a right radical mastectomy. Which of the following actions should the nurse take to prevent the development of lymphedema?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the plan of care for a client who has botulism poisoning. Which of the following interventions should the nurse include in the plan?

Correct Answer is A

Explanation

A nurse is reinforcing teaching about liquid iron supplements with a client who has anemia. Which of the following information should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is reinforcing teaching about a transcutaneous electrical nerve stimulation (TENS) unit for a client who has a herniated intervertebral disk. Which of the following statements by the client indicates an understanding of the teaching?

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A nurse is collecting data for an older adult client who has cystitis. Which of the following findings should the nurse expect? (Select all that apply.)

A nurse is assisting in developing the plan of care for a client with streptococcal pharyngitis. What is an appropriate action to include in the plan of care?

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A nurse is reviewing the medical record of a client who has hypertension and a new prescription for propranolol. Which of the following findings should the nurse identify as a contraindication for taking propranolol?

A nurse is reinforcing teaching with a client who has COPD and reports shortness of breath and little appetite. Which of the following instructions should the nurse include in the teaching?

A nurse is caring for a client who is experiencing muscle spasms and has a new prescription for an aquathermia pad. Which of the following actions should the nurse take?