Nokea
A 12-month-old client has a high blood lead level of 18 mcg/dL. The nurse is reinforcing teaching about lead poisoning to the parents. Which statements made by a parent indicate that teaching has been successful? Select all that apply.
- A. I should have our home inspected for the source of lead.
- B. I will vacuum our hard-surface floors daily.
- C. I will wash my child's hands often, especially before eating.
- D. We should use hot water from the tap for cooking.
- E. We will have to return for a follow-up lead level.
Correct Answer: A,C,E
Rationale: Inspecting the home identifies lead sources (e.g., paint, dust). Frequent hand washing reduces ingestion of lead dust. Follow-up testing monitors levels. Vacuuming may spread lead dust; wet mopping is preferred. Hot water can leach lead from pipes; cold water is safer.
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The spouse of a client calls the nurse at the clinic and reports that the client is not feeling well and is concerned that something is seriously wrong. How should the nurse respond initially?
- A. Ask the spouse to further describe the client's symptoms
- B. Indicate that privacy rules prevent discussion of concerns with the spouse
- C. Offer a same-day appointment to the client
- D. Tell the spouse to have the client call the nurse
Correct Answer: A
Rationale: Asking for symptom details helps assess urgency without violating privacy, as the spouse initiated contact. Privacy rules don't preclude initial fact-gathering, but direct client contact or an appointment may follow based on severity.
A 2-year-old in the emergency department is suspected of having intussusception. Which assessment finding should the nurse expect?
- A. Black, sticky stools
- B. Greasy, foul-smelling stools
- C. Stools mixed with blood and mucus
- D. Thin, 'ribbon-like' stools
Correct Answer: C
Rationale: Intussusception causes intestinal obstruction, often leading to 'currant jelly' stools (blood and mucus). Black, sticky stools suggest upper GI bleeding. Greasy stools indicate malabsorption. Ribbon-like stools suggest rectal narrowing.
Because a client has Addison's disease, the nurse would expect to see which of the following in the nursing assessment?
- A. A supraclavicular fat pad
- B. A puffy face
- C. Low blood pressure
- D. Ecchymotic areas
Correct Answer: C
Rationale: Addison's disease causes cortisol and aldosterone deficiency, leading to hypotension. Fat pads and puffy face are Cushing's symptoms, and ecchymosis is less specific.
During the discharge teaching of a client with Buerger's disease, the nurse should teach the client:
- A. Exercises for improving vascular return from the lower extremities
- B. The importance of wearing mittens or gloves
- C. Dietary choices for reducing triglycerides
- D. The role of weight bearing exercises in preventing bone loss
Correct Answer: A
Rationale: Exercises to improve vascular return, such as ankle pumps, help manage Buerger's disease by promoting circulation in the extremities.
The nurse is caring for a client with latent pulmonary tuberculosis who has been receiving isoniazid daily for the past 2 months. The client reports numbness and tingling in the hands and feet. The nurse should recognize that the client is likely experiencing a deficiency in
- A. iron
- B. vitamin B6
- C. folic acid
- D. vitamin D3
Correct Answer: B
Rationale: Isoniazid can deplete vitamin B6 (pyridoxine), causing peripheral neuropathy (numbness, tingling). Other deficiencies (iron, folic acid, vitamin D3) don't typically cause neuropathy.