Nokea
A 6-month-old is hospitalized with symptoms of botulism. What aspect of the infant's history is associated with Clostridium botulinum infection?
- A. The infant sucks on his fingers and toes.
- B. The mother sweetens the infant's cereal with honey.
- C. The infant was switched to soy-based formula.
- D. The father recently purchased an aquarium.
Correct Answer: B
Rationale: Honey can contain Clostridium botulinum spores, which are a common cause of infant botulism in children under 12 months, as their digestive systems cannot eliminate the spores.
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The nurse has received report on the day's assigned clients. Which of the following clients should the nurse see first?
- A. a client who is post-op day 2 from a spinal fusion at L34 with a pain level of 4 on a scale of 1-10
- B. a client with a peripheral IV on a 6-hour infusion with 42 cc remaining
- C. a client who is 6 hours post-atrial fibrillation ablation, is agitated, has a HR of 130 with B/P at 90/50, and has a urine output of 30 cc in the last 2 hours
- D. a client with a nasogastric tube in place who is complaining of gastric distress
Correct Answer: C
Rationale: The client post-atrial fibrillation ablation with agitation, tachycardia (HR 130), hypotension (BP 90/50), and low urine output (30 cc in 2 hours) indicates potential instability, requiring immediate assessment. This takes priority over stable post-op pain, an IV with remaining fluid, or gastric distress.
Four days after delivery, a client develops complications of postpartal hemorrhage. The most common cause of late postpartal hemorrhage is:
- A. Uterine atony
- B. Retained placental fragments
- C. Cervical laceration
- D. Perineal tears
Correct Answer: B
Rationale: Retained placental fragments are the most common cause of late postpartum hemorrhage, as they prevent proper uterine contraction and hemostasis.
A client with myasthenia gravis is admitted in a cholinergic crisis. Signs of of cholinergic crisis include:
- A. Decreased blood pressure and constricted pupils
- B. Increased heart rate and increased respirations
- C. Increased respirations and increased blood pressure
- D. Anoxia and absence of the cough reflex
Correct Answer: A
Rationale: Cholinergic crisis, due to excessive acetylcholinesterase inhibitors, causes symptoms like constricted pupils and decreased blood pressure from parasympathetic overstimulation.
A client admitted with gastroenteritis and a potassium level of 2.9 mEq/dL has been placed on telemetry. Which ECG finding would the nurse expect to find due to the client's potassium results?
- A. A depressed ST segment
- B. An elevated T wave
- C. An absent P wave
- D. A flattened QRS
Correct Answer: A
Rationale: Hypokalemia (2.9 mEq/dL) can cause a depressed ST segment, flattened T waves, and prominent U waves on ECG due to altered cardiac repolarization.
A client is receiving a blood transfusion following surgery. In the event of a transfusion reaction, any unused blood should be:
- A. Sealed and discarded in a red bag
- B. Flushed down the client's commode
- C. Sealed and discarded in the sharp's container
- D. Returned to the blood bank
Correct Answer: D
Rationale: Unused blood must be returned to the blood bank for analysis in case of a transfusion reaction.