GCC 1201 - 1225

A transjugular intrahepatic portosystemic shunt (TIPS) is performed for which condition?

• Portal hypertension.
• Ruptured esophageal varices.
• Jaundice.
• Jugular venous distension.
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A patient with pneumonia in the right lower lobe is prescribed percussion and postural drainage. When performing percussion and postural drainage, the nurse should position him:

• in semi-Fowler's position with his knees bent.
• in a right side-lying position with the foot of his bed elevated.
• in a prone or supine position with the foot of his bed elevated higher than his head.
• bent at the waist leaning slightly forward.
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The licensed practical nurse is observing a graduate nurse as she assesses the central venous pressure. Which observation would indicate that the graduate needs further teaching?

• The graduate places the client in a supine position to read the manometer.
• The graduate turns the stop-cock to the off position from the IV fluid to the client.
• The graduate instructs the client to perform the Valsalva maneuver during the CVP reading.
• The graduate notes the level at the top of the meniscus.
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A client with an abdominal cholecystectomy returns from surgery with a Jackson-Pratt drain. The chief purpose of the Jackson-Pratt drain is to:

• Prevent the need for dressing changes
• Reduce edema at the incision
• Provide for wound drainage
• Keep the common bile duct open
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A client is having a CAT scan and is worried about being in an enclosed space for the test. The client also states that antianxiety medications cause confusion. The client asks if there are other ways of helping control the fear while the scan is being done. The client reports attending yoga classes and finds guided imagery very relaxing. What is the nurse's best action to take with this client?

• Discuss the use of the breath work that the client does during yoga and inform the client that music headphones are available in the radiology department.
• Discuss the use of Reiki therapy and therapeutic touch during the CAT scan. Provide instruction in the use of these two methods during the CAT scan.
• Discuss use of the "Zone Diet" and meditation during the CAT scan as alternatives to yoga and guided imagery.
• Discuss the use of hypnotherapy as an alternative to the guided imagery that the client does during yoga.
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Which laboratory test result supports the diagnosis SLE?

• Elevated serum complement level
• Thrombocytosis and elevated sedimentation rate
• Pancytopenia and elevated antinuclear antibody (ANA) titer
• Leukocytosis and elevated blood urea nitrogen (BUN) and creatinine levels
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A client who takes tranylcypromine (Parnate) is changed to fluoxetine (Prozac). Which manifestation indicates a serious interaction between these two medications?

• Decreased salivary secretions.
• Complete heart block.
• Hyperthermia.
• Hypoactive reflexes.
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A client has just been admitted to the medical unit and the nurse is performing an initial physical assessment. The nurse finds that the client has difficulty hearing questions. The nurse also notices an empty glasses case that was sent up with the client from the emergency department. Based on this information, which action should first be taken by the nurse?

• Determine out of which ear the client hears best and if there is a hearing deficit in both ears. Then ask the client about the empty glasses case.
• Ask the client about use of any "assistive devices" and document the client's response.
• Look through the client's belongings to determine if there is a pair of glasses and a hearing aid.
• Notify the physician of the client's difficulty hearing and the empty glasses case.
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A client has received platelet infusions. Which finding would indicate the most therapeutic effect from the transfusions?

• Hgb level increase from 8.9 to 10.6
• Temperature reading of 99.4ºF
• White blood cell count of 11,000
• Decrease in oozing of blood from IV site
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A 36-year-old patient complains of fatigue, weight loss, and a low-grade fever. He also has pain in his fingers, elbows, and ankles. Which condition is suspected?

• Anemia
• Leukemia
• Rheumatic arthritis
• SLE
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