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A 20-year-old single parent brings her 3-year-old son into the emergency department because he 'fell.' The child has bruises on his face, arms, and legs; his mother says that she did not witness the fall. The nurse suspects child abuse. While examining the child, the mother says, 'Sometimes I guess I'm pretty rough with him. I'm alone, and I just don't know how to manage him.' The nurse should ask the mother if she would find it helpful to have a referral to:
- A. A program for single parents.
- B. A parenting education program.
- C. A women's support group.
- D. A support group for abusive parents.
Correct Answer: B
Rationale: A parenting education program would provide the mother with skills to manage her child's behavior appropriately, addressing potential abuse triggers and improving parenting techniques.
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The nurse is evaluating a diabetic client's understanding of the signs of hyperglycemia. Which statement by the client reflects an understanding?
- A. I may become diaphoretic and faint.
- B. I may notice signs of fatigue, dry skin, and increased urination.
- C. I need to take an extra diabetic pill if my blood glucose is greater than 300.
- D. I should restrict my fluid intake if my blood glucose is greater than 250.
Correct Answer: B
Rationale: Fatigue, dry skin, polyuria, and polydipsia are classic symptoms of hyperglycemia. Fatigue occurs because of lack of energy from the inability of the body to use glucose. Dry skin occurs secondary to dehydration related to polyuria. Polydipsia occurs secondary to fluid loss. Diaphoresis is associated with hypoglycemia. A client should not take extra hypoglycemic agents to reduce an elevated blood glucose level. A client with hyperglycemia becomes dehydrated secondary to the osmotic effect of the elevated glucose; therefore, the client must increase fluid intake.
The nurse judges that the parents of a newborn with imperforate anus know what a low defect is when they say that the rectum:
- A. Is below the abdominal rectus muscle
- B. Is above the abdominal rectus muscle
- C. Has descended through the puborectalis muscle
- D. Has ascended through the puborectalis muscle
Correct Answer: C
Rationale: A low defect in imperforate anus means the rectum has descended through the puborectalis muscle, indicating a less severe anomaly. Other options describe incorrect anatomical positions.
The nurse teaches a client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client has a need for further teaching if the client makes which statement?
- A. An anesthetic throat spray will be used.
- B. A signed informed consent is necessary.
- C. Medication will be given orally for sedation.
- D. It is important to lie still during the procedure.
Correct Answer: C
Rationale: Intravenous sedation (not oral) is given to relax the client, and an anesthetic throat spray is used to help keep the client from gagging as the endoscope is passed. The client has to sign an informed consent form. The client also needs to lie still for ERCP, which takes about an hour to perform.
A 17-year-old client has been admitted to the hospital for a biopsy to confirm the diagnosis of bone cancer. The nurse should assess the client for which conditions? Select all that apply.
- A. Cough.
- B. Dyspnea.
- C. Pain.
- D. Swelling.
- E. Fever.
- F. Anorexia.
- G. Decreased range of motion.
Correct Answer: C,D,E,F,G
Rationale: Bone cancer may cause pain, swelling, fever, anorexia, and decreased range of motion due to tumor effects on bone and surrounding tissues. Cough and dyspnea are less common unless metastasis occurs.
Which of the following laboratory tests should the nurse monitor when the client is receiving warfarin sodium (Coumadin) therapy?
- A. Partial thromboplastin time (PTT).
- B. Serum potassium.
- C. Arterial blood gas (ABG) values.
- D. Prothrombin time (PT).
Correct Answer: D
Rationale: Warfarin therapy requires monitoring prothrombin time (PT) to assess anticoagulation effectiveness.