Nokea
A 50 milliliter (ml) bolus of normal saline fluid is ordered by the physician. The physician wants it to infuse in 30 minutes. The nurse should set the pump rate at:
- A. 100 ml per hour for one hour.
- B. 60 ml per hour for one-half hour.
- C. 120 ml per hour for one hour.
- D. 50 ml per hour for one hour.
Correct Answer: A
Rationale: One hundred ml in one hour equals 50 ml in 30 minutes, which is what the physician prescribed. Choice 2 is 10 ml more than the physician prescribed for 30 minutes. Choice 3 is the same as Choice 2; it is 10 ml more than the physician prescribed for 30 minutes. Choice 4 only provides 25 ml over 30 minutes, or half the volume prescribed.
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A client asks the nurse what risk factors increase the chances of getting skin cancer. The risk factors include all except:
- A. Light or fair complexion
- B. Exposure to sun for great periods of time
- C. Certain diet and foods
- D. History of bad sunburns
Correct Answer: C
Rationale: Diet and foods are not established risk factors for skin cancer, unlike fair complexion, sun exposure, and history of sunburns.
A 32 year-old male with a complaint of dizziness has an order for Morphine via. IV. The nurse should do which of the following first?
- A. Check the patient's chest x-ray results.
- B. Retake vitals including blood pressure.
- C. Perform a neurological screen on the patient.
- D. Request the physician on-call assess the patient.
Correct Answer: B
Rationale: Dizziness can be a sign of hypotension, that may a contraindication with Morphine.
Which of the following substances need to be assessed when completing a family health assessment?
- A. coffee, tea, cola, and cocoa
- B. alcohol, tobacco, and illegal substances
- C. medicines prescribed by a physician
- D. all of the above
Correct Answer: D
Rationale: When assessing drug, alcohol, and tobacco practices among family members, a thorough investigation of prescribed, over-the-counter, and illegal substance-use practices should be made.
Which of the following client groups should the nurse recognize as the fastest-growing segment of the homeless population?
- A. Single, adult men
- B. Single mothers with 2 or 3 children
- C. Runaway adolescents
- D. Single, adult women
Correct Answer: B
Rationale: Single mothers with two or three children are the fastest-growing segment of the homeless population, often with young children, due to economic and social challenges.
Which of the following infant behaviors demonstrates the concept of object permanence?
- A. The infant cries when his mother leaves the room.
- B. The infant looks at the floor to find a toy that he was playing with and dropped.
- C. The infant picks up another toy after the one he was playing with rolls under the couch.
- D. The infant participates in a game of patty-cake.
Correct Answer: B
Rationale: Object permanence occurs when the infant learns that something/someone still exists even though they might not be able to see it/them. This develops between 9 and 10 months of age. If the infant cries when his mother leaves the room, it might be because he believes she is no longer in the house when he can't see her. If an infant picks up another toy after the one he is playing with rolls under the couch and the infant fails to look for it, he believes the toy that rolled under the couch no longer exists. Patty-cake is a game infants engage in but, it has nothing to do with object permanence. An infant game that does show object permanence is peek-a-boo. In this game, an infant continues to hunt for a hidden face because he believes it is still there.