Nokea
A 5-year-old child has been treated for sickle cell crisis. The parent asks the nurse if there is anything that can be done to prevent future crises. What should be included in the nurse's response?
- A. Sickle crisis is hard to predict and not usually preventable.
- B. Keeping the child from getting chilled may prevent a crisis.
- C. Fevers, vomiting, and diarrhea should be reported to the physician immediately.
- D. Giving the child aspirin on a daily basis lessens the frequency of crises.
Correct Answer: C
Rationale: Fevers, vomiting, and diarrhea can trigger sickle cell crisis by causing dehydration or infection, so prompt reporting allows early intervention to prevent crises.
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A 32-year-old man comes to the clinic for a glycosylated hemoglobin assay (HbA1c). The result is 6%. The nurse should
- A. document the findings in the chart.
- B. call the physician about orders to adjust the insulin dosage.
- C. give him 15 g of carbohydrates.
- D. ask him to list the foods he has eaten in the last 24 hours.
Correct Answer: A
Rationale: An HbA1c of 6% indicates good diabetes control (normal 4–6%). Documenting is appropriate as no action is needed. Options B, C, and D are unnecessary.
A clinic nurse is taking a health history from a 34-year-old man newly diagnosed with Buerger's disease. The nurse would expect the client's complaints to include
- A. heart palpitations.
- B. dizziness when walking.
- C. blurred vision.
- D. digital sensitivity to cold.
Correct Answer: D
Rationale: vasculitis of blood vessels in upper and lower extremities
The nurse is teaching home care to the parents of a child with acute spasmodic croup. The most important aspects of this care is/are
- A. sedation as needed to prevent exhaustion
- B. antibiotic therapy for 10 to 14 days
- C. humidified air and increased oral fluids
- D. antihistamines to decrease allergic response
Correct Answer: C
Rationale: humidified air and increased oral fluids. The most important aspects of home care for a child with acute spasmodic croup are humidified air and increased oral fluids. Moisture soothes inflamed membranes. Adequate systemic hydration aids in mucociliary clearance and keeps secretions thin, white, watery, and easily removed with minimal coughing.
Hospital staff requests that the parents with a Greek heritage of a hospitalized infant remove the amulet from around the child's neck. The parents refuse. The nurse understands that the parents may be concerned about
- A. Mental development delays
- B. Evil eye or envy of others
- C. Fright from spiritual beings
- D. Balance in body systems
Correct Answer: B
Rationale: Evil eye or envy of others. In Greek culture, amulets protect against 'matiasma' or the evil eye, especially for children.
The nurse is caring for a client with a history of hyponatremia.
- A. Which intervention is most appropriate for a client with hyponatremia?
- B. Administer hypertonic saline slowly.
- C. Encourage a low-sodium diet.
- D. Restrict fluid intake.
- E. Administer a diuretic.
Correct Answer: A
Rationale: Administering hypertonic saline slowly corrects hyponatremia by raising serum sodium levels, preventing cerebral edema. Low-sodium diets worsen hyponatremia, fluid restriction is for hypervolemic cases, and diuretics are contraindicated.