Saunders NCLEX-PN Questions with complete solution 2023

Saunders NCLEX-PN Questions with complete solution 2023 741. The nurse reinforces home care instructions to the parents of a child hospitalized with pertussis. The child is in the convalescent stage and is being prepared for discharge. Which statement by the parents indicates a need for further teaching? 1. "We need to encourage adequate fluid intake." 2. "Coughing spells may be triggered by dust or smoke." 3. "We need to maintain respiratory precautions and a quiet environment for at least 2 weeks." 4. "Good hand-washing techniques need to be instituted to prevent spreading the disease to others." - correct answer 741. 3 Rationale: Pertussis is transmitted by direct contact or respiratory droplets from coughing. The communicable period occurs primarily during the catarrhal stage. Respiratory precautions are not required during the convalescent phase. Options 1, 2, and 4 are components of home care instructions. Test-Taking Strategy: Note the strategic words, need for further teaching. These words indicate a negative event query and the need to select the incorrect statement. Options 1 and 4 can be easily eliminated because they are general interventions associated with convalescence. Knowing that coughing spells are associated with pertussis will assist in directing you to the correct option from the remaining options. In addition, a 2-week period of respiratory precautions is not required. Review: home care instructions for the child with pertussis. Level of Cognitive Ability: Evaluating Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Evaluation Content Area: Child Health: Infectious and Communicable Diseases Priority Concepts: Gas Exchange, Infection Reference(s): Hockenberry, Wilson (2013), pp. 428, 653-654. 742. A client enters the emergency department confused, twitching, and having seizures. His family states he recently was placed on corticosteroids for arthritis and was feeling better and exercising daily. Upon assessment, he has flushed skin, dry mucous membranes, an elevated temperature, and poor skin turgor. His serum sodium level is 172 mEq/L. Which interventions would the health care provider likely prescribe? Select all that apply. 1. Monitor the vital signs. 2. Monitor intake and output. 3. Increase water intake orally. 4. Monitor the electrolyte levels. 5. Provide a sodium-reduced diet. 6. Administer sodium replacements. - correct answer 742. 1, 2, 3, 4, 5 Rationale: Hypernatremia is described as having a serum sodium level that exceeds 145 mEq/L. Signs and symptoms would include dry mucous membranes, loss of skin turgor, thirst, flushed skin, elevated temperature, oliguria, muscle twitching, fatigue, confusion, and seizures. Interventions include monitoring fluid balance, monitoring vital signs, reducing dietary intake of sodium, monitoring electrolyte levels, and increasing oral intake of water. Sodium replacement therapy would not be prescribed for a client with hypernatremia. Test-Taking Strategy: Focus on the subject, a sodium level of 172 mEq/L. Knowledge that this level is elevated and knowledge of the treatment for hyperkalemia will direct you to the correct options. Review: hypernatremia. Level of Cognitive Ability: Analyzing Client Needs: Physiological Integrity Integrated Process: Nursing Process/Planning Content Area: Fundamental Skills: Fluids & Electrolytes Priority Concepts: Clinical Judgment, Fluid and Electrolyte Balance Reference(s): deWit, Kumagai (2013), pp. 41-42.