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質問 # 224
A 24-year-old man has been admitted to the hospital due to work-related back injury. The patient's wife would like to see the patient's chart.
The nurse should __________.
- A. tell the patient' wife, a copy of the patient's medical record is on-file with medical records
- B. provide the chart to the patient's wife following verbal approval by the patient
- C. provide the chart to the patient's wife after consulting with the patient's physician
- D. get written approval from the patient prior to providing the wife with chart information and call the MD about the patient's request
正解：D
解説：
Section: Safe and Effective Care Environment
Explanation:
Some facilities require the physician to be notified about a patient's request and written permission from the husband is required for the wife to view the chart.
質問 # 225
A patient has recently been prescribed Zidovudine (Retrovir). The patient has AIDS.
Which of the following side effects should the patient specifically watch out for?
- A. Weakness and SOB
- B. Fever and hypertension
- C. Fever and anemia
- D. Hypertension and SOB
正解：C
解説：
Section: Physiological Integrity
Explanation:
Anemia and fever are associated with Zidovudine's side effects.
質問 # 226
Levothyroxine (Synthroid) is the drug of choice for thyroid replacement therapy in clients with hypothyroidism because:
- A. it is not a prodrug.
- B. it has a short half-life.
- C. it is available in a single 25mg tablet, which makes dosing simple.
- D. it is chemically stable, nonallergenic, and can be administered orally once a day.
正解：D
解説：
Explanation/Reference:
Explanation:
Levothyroxine is safe and effective with virtually no side effects when dosed properly. A single, daily dose is possible because of the long half-life (7 days). Levothyroxine tablets are available in a wide range of concentrations to meet individual client requirements. Levothyroxine (T4) is a prodrug of T3.
Pharmacological Therapies
質問 # 227
A client has been placed in isolation because he is diagnosed with a contagious illness. The nurse should be aware that:
- A. Paper trays and plastic utensils prevent disease transmission.
- B. Linens from the client's bed should be double-bagged.
- C. Extensive isolation rarely causes psychological problems.
- D. Meals should be served on washable dishes.
正解：B
解説：
Explanation/Reference:
Explanation:
Linens should be double-bagged. Isolation refers to techniques used to prevent or to limit the spread of infection. Some form of isolation has been used for centuries, whether to protect a high-risk person from exposure to pathogens or to prevent the transmission of pathogens from an infected person to others.
Special handling of articles and linen soiled by any body fluid is indicated. These articles should be placed in impervious bags before they are removed from the client's bedside. Bagging in watertight containers is indicated to prevent exposure of personnel and contamination of the environment. The outside of the bag should not be contaminated when placing articles inside it. Each hospital and community agency has procedures for labeling and decontaminating exposed articles. Items that are visibly soiled with body substances should be rinsed and placed in plastic bags or clearly marked containers, often labeled
"Contaminated." If the outside of the bag becomes contaminated, placing that bag in another bag (double- bagging) is required. Safety and Infection Control
質問 # 228
Serum Vancomycin levels are taken to measure which of the following?
- A. antibiotic resistance
- B. trough levels
- C. renal function
- D. therapeutic range
正解：D
解説：
Explanation/Reference:
Explanation:
Vancomycin levels are monitored to ensure therapeutic effects by peak level. Trough level is that level of wash out or lowest level of drug just prior to the next dose. The blood is taken approximately 2 hours after an IV infusion. Renal function is measured by creatinine and BUN or creatinine clearance and resistance by sensitivity. Safety and Infection Control
質問 # 229
What happens if folic acid is given to treat anemia without determining its underlying cause?
- A. Intrinsic factor is destroyed.
- B. Excessive levels of folic acid might accumulate, causing toxicity.
- C. The symptoms of pernicious anemia might be masked, delaying treatment.
- D. Erythropoiesis is inhibited.
正解：C
解説：
Explanation/Reference:
Explanation:
Folic acid should not be used if pernicious anemia is suspected because it does not protect the client from CNS changes common to this type of anemia. Folic acid is usually given with Vitamin B12. Both are part of the Vitamin B complex and are essential for cell growth and division. Folic acid is sometimes used as a rescue drug for cells exposed to some toxic chemotherapeutic agents. The nature of the anemia must be confirmed to ensure that the proper drug regimen is being used. Physiological Adaptation
質問 # 230
A nurse is planning a brief treatment program for a client who was raped. A realistic, short-term goal is to:
- A. eliminate the client's enticing behaviors.
- B. resolve feelings of trauma and fear.
- C. identify all psychosocial problems.
- D. verbalize feeling about the event.
正解：D
解説：
A realistic short-term goal is for the client to verbalize feelings about the event. A brief treatment program is not designed to identify or resolve problems. The focus is on managing acute symptoms. If in-depth psychological problems are identified, the nurse might make referrals for treatment.Psychosocial Integrity
質問 # 231
The nurse and a colleague are on the elevator after their shift, and they hear a group of health caregivers discussing a recent client scenario. Which client right might be breached?
- A. right to reasonable responses to requests
- B. right to continuity of care
- C. right to confidentiality
- D. right to refuse treatment
正解：C
解説：
Explanation/Reference:
Explanation:
The right to confidentiality of client information might be breached when client care situations are discussed in public areas or without regard to maintaining the information as private and confidential. The other rights listed have not been breached in this instance. Coordinated Care
質問 # 232
Which of these scenarios would not be considered a violation of HIPAA laws?
- A. checking on your spouse's medical record because you are listed as her power of attorney
- B. looking up only the address (not the medical portion) in the chart of a co-worker who just delivered a baby so you can surprise her with a gift
- C. looking up the medical information of a friend not in your care but who gave you permission
- D. discussing discharge plans with a patient in a multi-bed recovery room with the curtain drawn around the patient's bed
正解：D
解説：
Section: Safe and Effective Care Environment
質問 # 233
Which of these statements from the caregiver of a palliative care patient indicates a proper understanding?
- A. This treatment plan usually means the prognosis is less than 6 months.
- B. The main therapeutic goals are comfort and better quality of life.
- C. We will need to stay in the hospital to receive this level of care.
- D. The medications to treat the underlying disease will be stopped.
正解：B
解説：
Section: Physiological Integrity
質問 # 234
A patient has recently been prescribed Zidovudine (Retrovir). The patient has AIDS. Which of the following side effects should the patient specifically watch out for?
- A. Weakness and SOB
- B. Fever and hypertension
- C. Fever and anemia
- D. Hypertension and SOB
正解：C
解説：
Explanation/Reference:
Explanation:
Anemia and fever are associated with Zidovudine's side effects.
質問 # 235
An elderly client denies that abuse is occurring. Which of the following factors could be a barrier for the client to admit being a victim?
- A. personal belief that abuse is deserved
- B. lack of developmentally appropriate screening tools
- C. fear of reprisal or further violence if the incident is reported
- D. knowledge that elder abuse is rare
正解：C
解説：
Explanation/Reference:
Explanation:
Barriers to reporting elder abuse include victim shame, fear of reprisals, fear of loss of caregiver, and lack of knowledge of agencies that provide services. Many elders fear that reporting abuse results in their placement in long-term care because the current caregiver is the abuser. Choices 1 and 3 are incorrect.
Choice 2 might be true but is not the best choice. Psychosocial Integrity
質問 # 236
The tendency of a drug to combine with its receptor is called:
- A. affinity.
- B. kinetics.
- C. efficacy.
- D. potency.
正解：A
解説：
Explanation/Reference:
Explanation:
Affinity is a close relationship, mutual attraction, or similarity. The tendency of a drug to combine with its receptor is called affinity. Affinity is a measure of the strength of the drug-receptor bonding. Choices 1 and
2 describe the capability of a drug to produce the desired effect. Choice 3 is the branch of science that deals with the effects of forces on the motions of material bodies or with changes in a physical or chemical system. Pharmacological Therapies
質問 # 237
Which of the following is the most appropriate diet for a client who is unable to swallow?
- A. clear liquids
- B. total parenteral nutrition
- C. nothing by mouth
- D. nasogastric feedings
正解：D
解説：
Nasogastric feedings are most appropriate for a client who is unable to swallow. Nothing by mouth leads to nutritional deficiencies. The client might aspirate a clear liquid diet. TPN is not necessary as long as the gut is still functioning.Reduction of Risk Potential
質問 # 238
Common problems for supervisors include all of the following except __________.
- A. the supervisor wants to control the style in which a staff member correctly performs a task.
- B. the supervisor facilitates development of staff members.
- C. the supervisor does not delegate.
- D. the supervisor micromanages staff members.
正解：B
解説：
Section: Safe and Effective Care Environment
Explanation:
Facilitating the development of staff members is an important goal for a supervisor.
Micromanagement, intolerance for individual differences in style, and inability to delegate all interfere with team building and overall effectiveness.
質問 # 239
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