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A 13-year-old female has been diagnosed with celiac disease. Which of the following dinner trays would be acceptable?
- A. baked chicken breast, carrots, baked potato with cheese
- B. turkey and cheese sandwich on wheat bread, cabbage slaw, apple slices
- C. spaghetti with meatballs, Caesar salad, banana
- D. pulled pork on flour tortillas, wild rice, black beans
Correct Answer: A
Rationale: Celiac disease requires a gluten-free diet. Option A (chicken, carrots, potato) is gluten-free, while others contain gluten (wheat bread, spaghetti, flour tortillas).
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A nurse on the orthopedics floor is asked by another nurse to witness her waste 1 mg of morphine. The nurse draws the full 2 mg dose of morphine into the syringe and tells the first nurse, 'This client does not get enough pain relief with 1 mg of morphine, so I just go ahead and give 2 mg to keep him comfortable because the doctor won't change the dose.' Which is the correct action by the first nurse?
- A. tell the other nurse to call the doctor back and request an increase in the dosage
- B. refuse to sign off on the waste and report the incident to the charge nurse or unit manager
- C. sign off the waste, and suggest that the nurse give it over two separate doses 30 minutes apart
- D. sign off the waste, but tell the nurse to give it slowly to be sure that the client can tolerate the dose
Correct Answer: B
Rationale: Administering an unordered dose is a medication error and potential diversion. Refusing to sign and reporting ensures patient safety and accountability.
The nurse is caring for clients on the neurology unit. What would be the MOST appropriate action for the nurse to take after noting that a client suddenly developed a fixed and dilated pupil?
- A. Reassess in five minutes.
- B. Check the client’s visual acuity.
- C. Lower the head of the client’s bed.
- D. Contact the physician.
Correct Answer: D
Rationale: implementation, fixed and dilated pupil represents a neurological emergency
The physician has ordered injections of Neumega (oprellvekin) for a client receiving chemotherapy for prostate cancer. Which finding suggests that the medication is having its desired effect?
- A. Hct 12.8 g
- B. Platelets 250,000 mm³
- C. Neutrophils 4,000 mm³
- D. RBC 4.7 million
Correct Answer: B
Rationale: Neumega (oprelvekin) stimulates platelet production, so a platelet count of 250,000 mm³ indicates effectiveness.
A client's admission history reveals complaints of fatigue, chronic sore throat, and enlarged lymph nodes in the axilla and neck. Which exam would assist the physician to make a tentative diagnosis of leukemia?
- A. A complete blood count
- B. An x-ray of the chest
- C. A bone marrow aspiration
- D. A CT scan of the abdomen
Correct Answer: A
Rationale: A complete blood count (CBC) is the initial test for leukemia, revealing abnormal white blood cell counts, anemia, or thrombocytopenia, supporting a tentative diagnosis.
The nurse is teaching the mother of an infant with eczema. Which of the following instructions should be included in the nurse's teaching?
- A. Dress the infant warmly to prevent undue chilling
- B. Cut the infant's fingernails and toenails regularly
- C. Use bubble bath instead of soap for bathing
- D. Wash the infant's clothes with mild detergent and fabric softener
Correct Answer: B
Rationale: Cutting nails regularly prevents scratching, which can worsen eczema and lead to infections in affected skin areas.