A nurse in a clinic is collecting data from a client who reports nausea, headache, weakness, and vertigo after turning on his furnace. The client's oral mucous membranes are cherry red. Then nurse should associate the client's manifestations with which of the following conditions?

Carbon monoxide poisoning

Stress

Septic shock

Heat stroke

Answer and Explanation

The Correct Answer is A

A. Carbon monoxide poisoning: CO poisoning presents with nonspecific symptoms like nausea, headache, dizziness, and cherry-red mucous membranes. Furnaces can emit CO if not ventilated properly.
B. Stress: Stress can cause headaches and fatigue, but not vertigo or cherry-red mucosa.
C. Septic shock: Septic shock typically presents with hypotension, fever or hypothermia, and poor perfusion-not cherry-red mucosa.
D. Heat stroke: Heat stroke causes high body temperature, altered mental status, and dry skin-not related to furnace use or cherry-red mucosa.

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Correct Answer is C

Explanation

A. The client's ability to communicate: Communication is important, but it is not the most critical factor in determining transfer method.
B. The client's activity tolerance: Activity tolerance affects length of mobility, but not necessarily the technique used for transfer.
C. The client’s current weight-bearing status: This determines whether the client needs full assistance, partial help, or assistive devices, and directly influences the transfer method and equipment used.
D. The type of equipment the staff used to transfer the client in the past: Past equipment may not match the client’s current condition.

A. "I plan to purchase a carbon monoxide detector for my home." B. "Breathing in carbon monoxide can cause headaches and nausea." C. "I can detect the presence of carbon monoxide by its metallic odor." D. "A high concentration of carbon monoxide can cause death."

Correct Answer is C

Explanation

A. "I plan to purchase a carbon monoxide detector for my home.": A CO detector is essential since carbon monoxide is undetectable by human senses.
B. "Breathing in carbon monoxide can cause headaches and nausea.": These are common early symptoms of carbon monoxide poisoning.
C. "I can detect the presence of carbon monoxide by its metallic odor.": Carbon monoxide is colorless, tasteless, and odorless. This indicates the client needs further teaching.
D. "A high concentration of carbon monoxide can cause death.": Prolonged or high-level exposure can be fatal due to tissue hypoxia.

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A nurse in a clinic is collecting data from a client who reports nausea, headache, weakness, and vertigo after turning on his furnace. The client's oral mucous membranes are cherry red. Then nurse should associate the client's manifestations with which of the following conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

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