A nurse is assessing a client who has intravenous therapy-related phlebitis. The nurse uses the Infusion Nurses Society's phlebitis scale to assess the severity of phlebitis and documents the client's phlebitis as grade level 1. Which of the following assessment findings correlates with a grade level of 1?

Purulent drainage at the intravenous site access site.

Redness at the intravenous access site with pain.

Red streaks on the affected extremity.

Palpable venous cord in the affected extremity.

Answer and Explanation

The Correct Answer is B

Choice A reason:
Purulent drainage at the intravenous site access site would indicate a more severe infection, possibly grade 3 or 4 on the Infusion Nurses Society's phlebitis scale. This would be associated with more advanced symptoms such as pus formation, which is not characteristic of grade 1 phlebitis.

Choice B reason:
Redness at the intravenous access site with pain is indicative of grade 1 phlebitis according to the Infusion Nurses Society's phlebitis scale. This grade is characterized by erythema and possible pain at the site of the IV insertion, without more severe symptoms such as swelling or streak formation.

Choice C reason:
Red streaks on the affected extremity suggest a progression of the inflammatory response, potentially indicating a higher grade of phlebitis, such as grade 2 or 3. This symptom suggests that the inflammation is spreading along the vein, which is more serious than grade 1 phlebitis.

Choice D reason:
A palpable venous cord in the affected extremity would also suggest a more severe form of phlebitis, likely grade 3. This occurs when a thrombus forms along with inflammation of the vein, leading to a palpable cord-like structure.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Unilateral swelling on the posterior of the vulva is not a typical symptom of endometrial cancer. While swelling can occur in the genital area due to various conditions, it is not specifically associated with endometrial cancer.

Choice B reason:
Extreme abdominal pain with intercourse, also known as dyspareunia, can be a symptom of many different conditions, including endometriosis and pelvic inflammatory disease, but it is not commonly associated with endometrial cancer. Endometrial cancer symptoms are more related to abnormal uterine bleeding rather than pain during intercourse.

Choice C reason:
Postmenopausal bleeding is a hallmark symptom of endometrial cancer. Any vaginal bleeding that occurs after menopause should be evaluated by a healthcare provider, as it can be an early sign of endometrial cancer.

Choice D reason:
Green, malodorous vaginal discharge can be a sign of an infection, such as bacterial vaginosis, but is not typically a symptom of endometrial cancer. While abnormal discharge can occur with endometrial cancer, it is usually bloody or watery, not green and malodorous.

A. Practice effective hand hygiene. B. Avoid serving raw foods. C. Wear barrier protection during vaginal intercourse. D. Avoid eating at fast food restaurants.

Correct Answer is A

Explanation

Choice A reason: Effective hand hygiene is the most important measure to prevent the transmission of hepatitis A, as the virus can be spread through close personal contact and by eating food or drinking water handled by someone who is infected¹. Handwashing with soap and water after using the bathroom, changing diapers, and before preparing or eating food is crucial.

Choice B reason: While avoiding raw foods can help prevent the transmission of various foodborne illnesses, hepatitis A is not commonly associated with raw foods unless they are contaminated during handling after cooking. However, it is still a good practice to avoid raw or undercooked foods in areas where hepatitis A is common.

Choice C reason:
Hepatitis A virus is primarily transmitted via the fecal-oral route, not through sexual contact. However, barrier protection can reduce the risk of transmission for many other infections, including other types of viral hepatitis that are sexually transmitted.

Choice D reason:
Eating at fast food restaurants is not inherently risky for hepatitis A transmission unless the food or water is contaminated. It is more important to ensure that all food is properly handled and cooked, regardless of the dining establishment.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a middle adult client who has just received the diagnosis of endometrial cancer. In taking a nursing history, which of the following manifestations is likely to be reported by this client?

Correct Answer is C

Explanation

A nurse is teaching a client who has hepatitis A about preventing the transmission of the virus. Which of the following strategies should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status?

A nurse is educating coworkers about how to minimize back strain and avoid repeated episodes of low back pain. Which of the following strategies should the nurse include? (Select all that apply.)

A nurse is developing a plan of care to prevent skin breakdown for a client with a spinal cord injury and paralysis. Which of the following nursing actions are appropriate? (Select all that apply.)

A nurse is teaching a client who has a pelvic fracture about the manifestations of fat embolism syndrome. The nurse should include which of the following findings as an early manifestation?

During a routine physical examination, a nurse observes a 1-cm (0.4-in) lesion on a client's chest. The lesion is raised and flesh-colored with pearly white borders. The nurse should recognize that this finding is suggestive of which of the following types of skin cancer?

A nurse is assessing a client's immune function by reviewing the laboratory value of the cellular response of the T-cells. The nurse should recognize that which of the following conditions is affected by the T-cells?

A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching?

A nurse in a provider's office is assessing a client who has wrist pain. Which of the following findings is a manifestation of carpal tunnel syndrome?