Nokea
A 15-month-old child has just been diagnosed with sickle cell anemia. The mother is pregnant and asks if the child she is carrying will also have sickle cell anemia. She says that neither she nor her husband has sickle cell anemia. The nurse's reply should be based on which understanding?
- A. There is a 50% chance that each child they have will have sickle cell anemia.
- B. The chance of having another child with sickle cell anemia is 1 in 4.
- C. Parents do not usually have two children in a row with sickle cell anemia.
- D. If the child is a boy, there is a 50% chance that he will have sickle cell anemia.
Correct Answer: B
Rationale: Sickle cell anemia is autosomal recessive; if both parents are carriers (trait), there's a 25% (1 in 4) chance per child of inheriting the disease, independent of gender or prior children.
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The nurse observes the student nurse enter wearing a gown, gloves, and a mask.
The nurse determines that the precautions are correct if the student nurse is caring for which of the following clients?
- A. An infant diagnosed with respiratory syncytial virus.
- B. A young child with a wound infected with S aureus.
- C. A teenager diagnosed with toxic shock syndrome.
- D. A teenager diagnosed with rubella (German measles).
Correct Answer: D
Rationale: Strategy: Determine the precautions required for each disease. (1) requires contact precautions, no mask (2) requires contact precautions, no mask (3) standard precautions (4) correct-droplet precautions used for organisms that can be transmitted by face-to-face contact, door may remain open
A two-year-old who is one-day postoperative.
The mother of a two-year-old who is one-day postoperative tells the nurse, 'My child is so restless and overactive.' The nurse should
- A. direct the LPN/LVN to obtain the child's vital signs.
- B. ask the mother if the child's sutures are still intact.
- C. tell the nursing assistant to take the child for a walk.
- D. check to see when the child last received pain medication.
Correct Answer: D
Rationale: Strategy: Answers are a mix of assessments and implementations. Does this situation require validation? Yes. Determine the best assessment. (1) no indication that there are any problems (2) passing the buck (3) implementation, should first assess (4) correct-young children typically become restless and overactive if in pain, grimacing, clenching teeth, rocking, and aggressive behavior may also be observed
The nurse is caring for a client who is post-op following a thoracotomy. The client has 2 chest tubes in place, connected to 1 chest drain. The nursing assessment reveals bubbling in the water seal chamber when the client coughs. What is the most appropriate nursing action?
- A. Clamp the chest tube
- B. Call the surgeon immediately
- C. Continue to monitor the client to see if the bubbling increases
- D. Instruct the client to try to avoid coughing
Correct Answer: C
Rationale: Bubbling associated with coughing after lung surgery is to be expected as small amounts of air escape the pleural space when pressures inside the chest increase with coughing. Monitoring is the only nursing action required at this time.
The nurse is teaching a client how to perform self-monitoring blood glucose (SMBG) using a blood glucose monitor.
Which of the following actions, if performed by the client, indicates to the nurse the need for further teaching?
- A. The client lets her hand dangle before sticking her finger with the lancet.
- B. The client sticks her finger on the side of the distal phalanx.
- C. The client touches the strip with a large drop of blood hanging from her fingertip.
- D. The client milks her finger after sticking it.
Correct Answer: D
Rationale: Strategy: 'Further teaching' indicates an incorrect response. (1) helps to facilitate venous congestion (2) less painful than the center of the fingertip (3) blood should sit on the strip like a raindrop, smearing alters the reading (4) correct-forces interstitial fluid to mix with capillary blood and dilutes the blood
Triage refers to the classification of injury severity during a disaster. Which of the following clients should receive priority during triage?
- A. Open fractures of the tibia and fibula
- B. Burns of the head and neck
- C. Crushing injury of the arm
- D. Contusions and lacerations of the head without loss of consciousness
Correct Answer: B
Rationale: Burns to the head and neck are prioritized due to potential airway compromise, a life-threatening condition. Open fractures, crushing injuries, and minor head injuries are less immediately critical.