A 6-year-old child is alert but quiet when brought to the emergency center with periorbital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with the basilar skull fracture?
- A. Blurred vision.
- B. Shoulder pain.
- C. Abdominal pain.
- D. Rhinorrhea or otorrhea with halo sign.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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During a follow-up visit, a client with diabetes reports difficulty maintaining a healthy diet. What should the nurse do first?
- A. provide the client with meal planning resources
- B. explore the client's dietary habits and challenges
- C. refer the client to a nutritionist
- D. educate the client on the importance of a healthy diet
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
During a home health visit the nurse notices that an older male client with type 2 diabetes mellitus is wearing loose cloth slippers. The client reports that he cannot comfortably wear other shoes because his toenails get in the way. The nurse inspects the clients feet and finds long thick nails that curl down under some of the toes. Which action should the nurse take?
- A. demonstrate proper foot care to client and family
- B. have a home health aide assist client with hygiene weekly
- C. schedule an appointment for the client with podiatrist
- D. trim the clients toenails gradually over several visits
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding requires immediate intervention?
- A. Oxygen saturation of 88%.
- B. Use of accessory muscles for breathing.
- C. Respiratory rate of 26 breaths per minute.
- D. Barrel-shaped chest.
Correct Answer: C
Rationale: A respiratory rate of 26 breaths per minute is an abnormal finding and indicates that the client is experiencing respiratory distress, requiring immediate intervention. This rapid respiratory rate can signify inadequate oxygenation and ventilation. Oxygen saturation of 88% is low but not as immediately concerning as a high respiratory rate, which indicates the body is compensating for respiratory distress. The use of accessory muscles for breathing and a barrel-shaped chest are typical findings in clients with COPD but do not indicate an immediate need for intervention as they are more chronic in nature and may be seen in stable COPD patients.
The nurse is planning a community health fair to promote mental health awareness. Which activity is most likely to engage participants?
- A. a lecture on the signs and symptoms of depression
- B. a workshop on stress management techniques
- C. a panel discussion with mental health experts
- D. a booth distributing brochures on mental health resources
Correct Answer: B
Rationale: A workshop on stress management techniques is the most engaging activity as it allows participants to actively participate, learn practical skills, and interact with others. This hands-on approach fosters engagement and provides attendees with tools they can directly apply in their lives. Choice A, a lecture, may be informative but lacks the interactive element that promotes engagement. Choice C, a panel discussion, might be informative but could be passive for attendees. Choice D, distributing brochures, is informative but lacks the interactive and engaging nature of a workshop.
The nurse is preparing a presentation on sexually transmitted infections (STIs) for a group of high school students. Which strategy is most effective for this age group?
- A. providing detailed statistical data on STI rates
- B. distributing brochures about STI prevention
- C. showing a documentary on the impact of STIs
- D. facilitating a discussion on safe sex practices
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.