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A 9 year-old is taken to the emergency room with right lower quadrant pain and vomiting. When preparing the child for an emergency appendectomy, what must the nurse expect to be the child's greatest fear?
- A. Change in body image
- B. An unfamiliar environment
- C. Perceived loss of control
- D. Guilt over being hospitalized
Correct Answer: C
Rationale: For school-age children, major fears are loss of control and separation from friends/peers.
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The nurse reviews a client's medical record and notes the following PRN medication prescriptions: acetaminophen, haloperidol, and benztropine. The nurse would administer a dose of benztropine on assessing which client behavior?
- A. Muscle rigidity and shuffling gait
- B. Nihilistic delusions
- C. Tangential speech
- D. Waxy flexibility
Correct Answer: A
Rationale: Benztropine is an anticholinergic used to treat extrapyramidal symptoms (EPS), such as muscle rigidity and shuffling gait, which are side effects of antipsychotics like haloperidol.
Which instructions should the nurse include when reinforcing discharge teaching to a client with peptic ulcer disease due to Helicobacter pylori infection? Select all that apply.
- A. Avoid foods that may cause epigastric distress such as spicy or acidic foods.
- B. It is best if you refrain from consuming alcohol products.
- C. Report black tarry stools to your health care provider immediately
- D. Take your amoxicillin, clarithromycin, and omeprazole for the next 14 days.
- E. You may take over-the-counter drugs such as aspirin if you have mild epigastric pain.
Correct Answer: A,B,C,D
Rationale: Avoiding irritants (A), abstaining from alcohol (B), reporting melena (C), and completing the antibiotic regimen (D) are critical for managing H. pylori-related peptic ulcer disease.
The nurse is talking with a client who has urge incontinence and is receiving tolterodine. It would require immediate follow-up if the client reports
- A. straining to have a bowel movement
- B. going an entire workday without needing to urinate
- C. using over-the-counter artificial saliva products for dry mouth
- D. experiencing occasional dizziness in the morning and with position changes
Correct Answer: B
Rationale: Not urinating for an entire workday suggests urinary retention, a serious side effect of tolterodine, requiring immediate evaluation to prevent bladder damage.
The nurse is talking with the parent of a pediatric client who had a cast applied to the right arm 30 minutes ago. Which of the following statements by the parent would require follow-up?
- A. I understand that my child may feel tingling or burning underneath the cast for the first few days.
- B. I can use a hair dryer to blow cool air underneath the cast if my child experiences itching.
- C. I will call the clinic if my child experiences pain that is not relieved with medication.
- D. I should keep my child's arm elevated while resting for the first few days.
Correct Answer: A
Rationale: Tingling or burning may indicate neurovascular compromise or pressure on nerves, requiring immediate evaluation, not dismissal as normal.
A nurse is admitting a client at 42 weeks gestation to the labor and delivery unit for induction of labor. What is a predictor of a successful induction?
- A. Bishop score of 10
- B. Firm and posterior cervix
- C. History of precipitous labor
- D. Reactive nonstress test
Correct Answer: A
Rationale: A Bishop score of 10 indicates a favorable cervix (soft, dilated, effaced, anterior), predicting a higher likelihood of successful induction.