Nokea
A 6-year-old child is admitted to the hospital for heart surgery to repair tetralogy of Fallot. The child asks the nurse if the cardiac catheterization will hurt. Which of the following statements offers the nurse the best guide for responding to the child's question?
- A. The medication used to numb the insertion site will sting
- B. Momentary sharp pain usually occurs when the catheter enters the heart
- C. It is usual for a 6-year-old to feel discomfort during the procedure
- D. It is a painless procedure, although a tingling sensation may be felt in the extremities
Correct Answer: A
Rationale: The local anesthetic used at the insertion site for cardiac catheterization may cause a stinging sensation, which is an honest and appropriate response for a 6-year-old. Pain is not typically felt when the catheter enters the heart, and discomfort or tingling is not a standard experience.
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The nurse observes an 18-month-old who has been admitted with a respiratory tract infection (see figure). The nurse should first:
- A. Position the child supine
- B. Call the rapid response team
- C. Offer the child a carbonated drink
- D. Place the child in a croup tent
Correct Answer: B
Rationale: An 18-month-old with a respiratory tract infection may be in respiratory distress, requiring immediate action by calling the rapid response team. Positioning supine or offering a drink could worsen breathing, and a croup tent is specific to croup, not all infections.
A nurse is assessing an 82-year-old for depression, because of the client's age, the nurses' assessment should be guided by the fact that:
- A. Sadness of mood is usually present but it is masked by other symptoms.
- B. Impairment of cognition usually is not present.
- C. Psychosomatic tendencies do not tend to dominate.
- D. Antidepressant therapies are less effective in older adults.
Correct Answer: A
Rationale: In older adults, depression may present with atypical symptoms, such as somatic complaints or irritability, rather than overt sadness, which can mask the condition.
A client with a history of heart failure is prescribed carvedilol (Coreg). The nurse should monitor the client for which of the following side effects?
- A. Hypertension.
- B. Bradycardia.
- C. Hyperglycemia.
- D. Weight loss.
Correct Answer: B
Rationale: Carvedilol, a beta-blocker, can cause bradycardia, requiring close monitoring of heart rate.
A client with a history of chronic lymphocytic leukemia is prescribed prednisone. The nurse should monitor the client for which of the following side effects?
- A. Hypoglycemia.
- B. Weight gain.
- C. Hypotension.
- D. Hair loss.
Correct Answer: B
Rationale: Prednisone, a corticosteroid, commonly causes weight gain due to fluid retention and increased appetite.
When the nurse is assessing a client's cultural adaptation, which of the following statements is least sensitive to the client's needs?
- A. What are some of your favorite foods?'
- B. Describe any health problems in your past.'
- C. Please tell me how you would like to be addressed.'
- D. Your eyes look dark; is this normal for you?'
Correct Answer: D
Rationale: Commenting on the client's appearance (dark eyes) is insensitive and irrelevant to cultural adaptation, potentially making the client uncomfortable.