Nokea
A 12-year-old male is brought to his primary care provider to determine whether sexual abuse has occurred. The mother states, 'Because there is no permanent physical damage, he does not need any more treatment.' The nurse's response should be based on which of the following pieces of information?
- A. Male victims of sexual abuse seldom have long-term psychological problems.
- B. Survivors of male sexual abuse might become confused about their sexual identity.
- C. Unless treated, all male sex abuse survivors grow up to abuse other children.
- D. All children who have been sexually abused have the same needs, regardless of gender.
Correct Answer: B
Rationale: Male sexual abuse survivors may experience confusion about sexual identity, necessitating psychological support. The other statements are incorrect: long-term issues are common, not all survivors become abusers, and needs vary by gender. Psychosocial Integrity
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Which statement describes factors that help build personal power in an organization?
- A. Longevity in an organization, social ties to people in power, and a history as someone who does not back down in conflict ends with success
- B. Goals are met with the use of networking, mentoring, and coalition building
- C. High visibility and formal power are maintained with a confrontational style
- D. Credibility to one's position is enhanced when professional dress and demeanor are employed
Correct Answer: B
Rationale: Networking, mentoring, and coalition building are positive uses of personal power to meet goals.
Right documentation includes the name, dosage, route, and time of administration. When should you sign your initials on the medication administration record?
- A. Immediately before the dose is given
- B. Immediately after the dose has been given
- C. Immediately before the dose is given, in the medication room
- D. Within one hour after administering the medication
Correct Answer: B
Rationale: Signing immediately after administration confirms the dose was given, ensuring accurate documentation. Signing before risks errors, and waiting an hour delays accuracy.
A client with a history of Addison's disease and flulike symptoms accompanied by nausea and vomiting over the past week is brought to the facility. The client's wife reports that she noticed that he acted confused and was extremely weak when he woke up in the morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101°F (38.3°C). A diagnosis of acute adrenal insufficiency is made. Which of the following would the nurse expect to administer by I.V. infusion?
- A. Insulin
- B. Hydrocortisone
- C. Potassium
- D. Hypotonic saline
Correct Answer: B
Rationale: Emergency treatment for acute adrenal insufficiency (addisonian crisis) is I.V. infusion of hydrocortisone and saline solution. The client is usually given 100 mg of hydrocortisone in normal saline every 6 hours until his blood pressure returns to normal. Insulin isn't indicated in this situation because adrenal insufficiency is usually associated with hypoglycemia. Potassium isn't indicated because these clients are usually hyperkalemic. The client needs normal - not hypotonic - saline solution.
The nurse is preparing to perform a physical examination on an 8 month-old who is sitting contentedly on his mother's lap. Which of the following should the nurse do first?
- A. Elicit reflexes
- B. Measure height and weight
- C. Auscultate heart and lungs
- D. Examine the ears
Correct Answer: C
Rationale: Auscultate heart and lungs. Performing this during a quiet moment ensures clear sound detection.
The nurse should explain to a client that tolbutamide (Orinase) is effective for diabetics who
- A. can no longer produce any insulin.
- B. produce minimal amounts of insulin.
- C. are unable to administer their injections.
- D. have a sustained decreased blood glucose.
Correct Answer: B
Rationale: Tolbutamide, an oral hypoglycemic, is effective for type 2 diabetes patients who produce minimal insulin, stimulating insulin release. Type 1 diabetics (A) produce no insulin, injection inability (C) is irrelevant, and low blood glucose (D) is not an indication for tolbutamide.