Nokea
A 14-year-old boy is being admitted to the hospital for an appendectomy. Which roommate should the nurse assign with this patient?
- A. A 4-year-old boy post-appendectomy surgery
- B. A 6-year-old boy with pneumonia
- C. A 15-year-old boy admitted with a vasoocclusive sickle cell crisis
- D. A 12-year-old boy with cellulitis
Correct Answer: C
Rationale: The nurse should assign the 14-year-old boy recovering from an appendectomy to Roommate C, the 15-year-old boy admitted with a vasoocclusive sickle cell crisis. This decision is based on providing similar age groups and conditions for mutual support and understanding. Both patients are teenagers and are experiencing health challenges that involve pain management and supportive care. This pairing can offer emotional and social benefits as they navigate their hospital stay together. It is important to consider factors like age, condition, and potential social interactions when assigning roommates in a healthcare setting to promote a positive environment for healing and recovery.
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What is the last step when inserting an IV cannula?
- A. Secure the cannula with tape.
- B. Document the insertion site, date, and type of cannula used.
- C. Assess the site
- D. Place a sterile dressing over the insertion site. INFLAMMATORY AND INFECTIOUS DISTURBANCES Caring for clients with upper respiratory infections
Correct Answer: D
Rationale: The last step when inserting an IV cannula is to place a sterile dressing over the insertion site. This helps to protect the site from contamination and reduce the risk of infection. A sterile dressing also helps to maintain the integrity of the insertion site and prevent any foreign materials from entering the wound. Additionally, the dressing provides a barrier between the cannula site and the external environment, promoting healing and reducing the chance of complications.
Vitamin A supplementation may be recommended for the young child who has which disease?
- A. Mumps
- B. Rubella
- C. Measles (rubeola)
- D. Erythema infectiosum
Correct Answer: C
Rationale: Vitamin A supplementation may be recommended for children with measles (rubeola) due to the disease's association with vitamin A deficiency. Measles can lead to reduced levels of vitamin A in the body, which can result in increased severity of symptoms, complications, and even death. Supplementing with vitamin A during and after a measles infection helps reduce the risk of complications and mortality, particularly in young children under the age of 5 in areas where vitamin A deficiency is common. Therefore, providing vitamin A supplementation to children with measles is an important intervention to support their recovery and improve outcomes.
Which of the ff should the nurse identify as the earliest symptom of heart failure in many older clients?
- A. Increased urine output
- B. Dyspnea on exertion
- C. Swollen joints
- D. Nausea and vomiting
Correct Answer: B
Rationale: Dyspnea on exertion is often identified as the earliest symptom of heart failure in many older clients. This symptom occurs due to the heart's inability to pump blood efficiently, leading to a buildup of fluid in the lungs. As a result, individuals may experience shortness of breath when engaging in physical activity or even at rest. Monitoring for dyspnea on exertion can aid in the early detection and management of heart failure in older clients. Other symptoms, such as increased urine output, swollen joints, and nausea/vomiting, may also occur in heart failure, but dyspnea on exertion is typically considered one of the earliest signs to manifest.
Patient S is a sexually active adolescent; which of the following instructions would be included in the preventive teaching plan about urinary tract infections?
- A. Drinking acidic juices
- B. Avoiding urinating before intercourse
- C. Wearing nylon underwear
- D. Wiping back to front
Correct Answer: A
Rationale: Drinking acidic juices, such as cranberry juice, can help make the urine more acidic, which can potentially prevent bacteria from sticking to the urinary tract walls and reduce the risk of urinary tract infections. It is important to note that while acidic juices can be beneficial in some cases, they should not be relied upon as the sole preventive measure for UTIs. Other important preventive measures include staying hydrated, practicing good hygiene, and urinating before and after intercourse.
Before administering a food feeding the nurse knows to perform which of the following assessments/
- A. The GI tract, including bowel sounds, last BM, and distention f. The client's neurologic status, especially the gag reflex
- B. The amount of air in the stomach
- C. That the formula is used directly from the refrigerator
Correct Answer: A
Rationale: Before administering a food feeding, the nurse knows to perform assessments related to the GI tract, including bowel sounds, last bowel movement, and distention. These assessments help evaluate the patient's digestive system function and readiness for food intake. In addition, assessing the client's neurologic status, especially the gag reflex, is crucial before initiating feeding to prevent aspiration and ensure safe swallowing. These assessments help ensure the safety and well-being of the patient during the feeding process. Checking the amount of air in the stomach and ensuring that the formula is used directly from the refrigerator are not primary assessments that need to be performed before administering a food feeding.