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A |mother |runs |into |the |emergency |department |with |a |toddler |in |her |arms |and |tells |the |nurse |that |her
child |got |into |some |cleaning |products. |the |child |smells |of |chemicals |on |the |hands, |face, |and |on |the
front |of |the |child's |clothes. |after |ensuring |the |airway |is |patent, |what |action |should |the |nurse
|
implement |first?
|
a. Assess |the |child |for |altered |sensorium
b. Determine |type |of |chemical |exposure
c. Obtain |equipment |for |gastric |lavage
d. Call |poison |control |emergency |number |- |✅✅✅b. |Determine |type |of |chemical |exposure
Which |conditions |are |most |likely |to |respond |to |treatment |with |antihistamines? |Select |all |that |apply.
a. Bronchitis
b. Allergic |rhinitis
c. Otitis |media
d. Contact |dermatitis
e. Myocarditis |- |✅✅✅b. |Allergic |rhinitis
d. |Contact |dermatitis
An |older |client's |daughter |calls |the |home |health |nurse |and |reports |that |her |mother |has |become
|forgetful |and |is |very |confused |at |night. |The |daughter |states |that |her |mother's |behavior |changed
|suddenly |a |few |days |ago |and |is |now |getting |worse. |Which |action |should |the |nurse |take? |Select |all
|that |apply.
a. Ask |if |the |mother |is |experiencing |any |pain |with |urination
b. Encourage |increased |intake |of |high |protein |foods
c. Instruct |the |daughter |to |check |her |mother's |temperature
d. Review |the |client's |current |food |and |medication |allergies
,P |a |g |e | 1 || |48
,e. Determine |if |the |mother |has |recently |experienced |a |fall |- |✅✅✅a. |Ask |if |the |mother |is
|experiencing |any |pain |with |urination
c. |Instruct |the |daughter |to |check |her |mother's |temperature
e. |Determine |if |the |mother |has |recently |experienced |a |fall
The |nurse |is |assessing |a |male |with |a |history |of |Addison's |disease. |The |client |has |flu-like |symptoms
|and |nausea |with |vomiting |over |the |past |week. |The |client's |spouse |reports |that |he |acted |confused
|and |was |extremely |weak |when |he |awoke |this |morning. |The |client |is |febrile |and |has |tachycardia. |The
|health |care |provider |diagnoses |acute |adrenal |insufficiency. |Which |medication |will |most |likely |be
|prescribed?
a. Hypertonic |saline |solution |at |100 |ml/hr |until |all |edema |disappears
b. Hydrocortisone |100 |mg |IV |every |six |hours |until |systolic |BP |reaches |110 |mmHg
c. Potassium |chloride |20 |mEq |IV |to |infuse |over |2 |hours |until |confusion |resolves
d. Regular |insulin |drip |to |keep |blood |glucose |around |100 |mg/dl |(5.55 |mmol/L) |-
|✅✅✅b. |Hydrocortisone |100 |mg |IV |every |six |hours |until |systolic |BP |reaches |110
|mmHg
A |client |with |a |history |of |mitral |valve |prolapse |is |admitted |because |of |fever |and |dyspnea |on |exertion,
|and |is |diagnosed |with |acute |infective |endocarditis. |During |the |admission |assessment, |the |nurse
|observes |multiple |areas |of |petechiae |on |the |client's |skin. |Which |intervention |should |the |nurse
|include |in |the |client's |plan |of |care? |Select |all |that |apply.
a. Monitor |cardiac |rhythm |via |telemetry
b. Report |changes |in |pre-existing |murmurs
c. Schedule |rest |periods |between |activities
d. Maintain |record |of |fluid |intake |and |output
e. Initiate |contact |transmission |precautions |- |✅✅✅a. |Monitor |cardiac |rhythm |via |telemetry
b. |Report |changes |in |pre-existing |murmurs
e. |Initiate |contact |transmission |precautions
P |a |g |e | 2 || |48
, The |nurse |is |planning |an |educational |session |for |new |parents |on |ways |to |prevent |sudden |infant |death
|syndrome |(SIDS). |Which |information |is |most |important |to |provide |parents |of |newborns |and |infants?
a. Remove |pillows |and |soft |toys |from |the |crib |at |bedtime
b. Keep |a |bulb |syringe |accessible |for |use |for |an |infant
c. Position |the |infant |in |a |supine |position |while |sleeping
d. Do |not |prop |bottles |for |an |infant |during |naps |and |bedtime |- |✅✅✅c. |Position |the |infant |in |a
|supine |position |while |sleeping
The |healthcare |provider |prescribes |methylergonovine |maleate |for |a |postpartum |client |with |uterine
|atony. |What |findings |should |indicate |to |the |nurse |to |withhold |the |next |dose |of |medication?
a. Hypertension
b. Difficulty |locating |the |uterine |fundus
c. Saturation |of |more |than |one |pad |per |hour
d. Excessive |lochia |- |✅✅✅a. |Hypertension
The |nurse |notes |that |an |older |adult |client |has |a |moist |cough |that |increases |in |severity |during |and |after
|meals. |Based |on |this |finding, |which |action |should |the |nurse |take?
a. Collect |a |sputum |specimen |immediately
b. Request |a |consultation |to |confirm |dysphasia
c. Offer |the |client |additional |clear |liquids |frequently
d. Encourage |the |client |to |do |deep |breathing |exercises |daily |- |✅✅✅b. |Request |a |consultation
|to |confirm |dysphasia
A |multiparous |client |who |delivered |her |infant |3 |hours |ago |asks |the |nurse |if |she |can |take |a |warm |sitz |bath
|because |it |helped |reduce |perennial |pain |after |her |last |delivery. |What |action |should |the |nurse
implement?
a. Using |analgesic |spray |to |the |perennial |area |to |reduce |pain
b. Apply |an |ice |pack |to |the |perineum |for |the |first |24 |hours
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