6. A 55-year-old client, who is a renowned pianist, is admitted to the neurology unit after a right-sided cerebrovascular accident (CVA) following a high-pressure concert performance. The client’s family is anxious about the potential implications on his career. The nurse is performing a neurological assessment while considering the client’s profession and the family’s concerns. Amidst the assessment, which finding should prompt the nurse to take immediate action and possibly escalate care?

A. Decrease in the level of consciousness

B. Loss of bladder control

C. Altered sensation to stimuli, especially in the fingers

D. Emotional lability, with episodes of sudden crying

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7. A 6-year-old child, who has recently moved to a high-altitude region with his family, has been diagnosed with cystic fibrosis. The parents bring him to a pediatric clinic for an initial assessment and are concerned about how the altitude might impact his condition. They also mention that he has been more active and playing outside with new friends. Considering the early stage of this disease and the child’s recent environmental changes, which later-stage symptom associated with cystic fibrosis would the nurse NOT expect to observe at this time?

A. Positive sweat test

B. Bulky greasy stools

C. Moist, productive cough

D. Meconium ileus

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8. During a home health visit in a remote mountainous area with limited cell reception, a nurse arrives at a cabin to find a male client lethargic and confused. His wife, who seems visibly distressed, mentions that he fell down the stairs approximately two hours ago while they were preparing for a storm. She adds that he seemed fine immediately afterward and didn’t want to worry their children who are playing in the adjacent room. Given the circumstances, what actions should the nurse prioritize? Select all that apply.

A. Place a call to the client’s health care provider for instructions, even if it means driving to a location with better reception.

B. Arrange for immediate transport or send him to the nearest emergency room for evaluation.

C. Reassure the client’s wife that the symptoms are likely to be transient and will resolve soon.

D. Instruct the client’s wife to monitor his condition and to call the doctor if symptoms worsen, providing her with emergency numbers.

E. Assess for other signs of head trauma like pupil dilation, irregular breathing, or fluid drainage from ears or nose.

F. Keep the client in a calm and quiet environment, away from the children, to reduce stimulation.

G. Check the home environment for potential hazards that could lead to further injury.

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9. A 72-year-old client with a history of recurrent urinary tract infections and recent complaints of flank pain is scheduled for KUB (Kidney, Ureter, Bladder) radiography in an outpatient setting. The client is anxious and mentions reading various preparation methods online. Given the client’s age, history, and concerns, which of the following actions should the nurse take to adequately prepare the client for the test? Select all that apply. 

A. Instruct the client that they must be NPO for 6 hours before the examination.

B. Administer an enema the evening before the examination to ensure clear imaging.

C. Administer furosemide 20 mg IV half an hour before the examination to enhance visualization.

D. Reassure the client and inform them that no special preparation is needed for this examination.

E. Ask the client to drink fluids and empty the bladder just prior to the examination to ensure a clear view.

F. Check for any allergies to contrast, even though it’s not typically used in a standard KUB.

G. Advise the client to wear loose-fitting clothing without any metal objects for the examination.

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10. The nurse is giving discharge teaching to a 45-year-old client, a professional athlete, seven (7) days post-myocardial infarction. The client, anxious about returning to his normal life and activities, asks the nurse why he must wait six (6) weeks before having sexual intercourse. He also inquires about the impact on his athletic performance. Given his profession and concerns, what is the best response by the nurse to this question?

A. “You need to regain your strength before attempting such exertion, especially considering your profession.”

B. “When you can climb 2 flights of stairs without problems or feeling short of breath, it is generally safe to engage in activities like sex.”

C. “Have a glass of wine to relax you, then you can try to have sex.”

D. “Your heart needs time to heal, and premature exertion can risk another cardiac event.”

E. “You should consider discussing this with your cardiologist, who can provide guidelines tailored to your athletic needs.”

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