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A client is scheduled for a computed tomography (CT) of the brain with contrast. When reviewing the client's medical record, what significant finding should the nurse report to the primary healthcare provider before the diagnostic procedure?
- A. The client takes metformin daily.
- B. The client has not been nothing by mouth (NPO).
- C. The client reports an allergy to gadolinium.
- D. The client was not prescribed a bowel prep.
Correct Answer: A
Rationale: Metformin (A) is significant before a CT with contrast due to lactic acidosis risk if renal function declines from contrast dye. NPO status (B) isn't critical for brain CT. Gadolinium (C) is MRI-related, not CT. Bowel prep (D) is irrelevant. A is correct. Rationale: Contrast can impair kidneys, exacerbating metformin toxicity, requiring provider adjustment, per radiology safety protocols.
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You highly suspect that your assigned client has abdominal distention. You most need to do and chart which of the following things?
- A. Have another nurse verify your suspicions.
- B. Measure the abdominal girth at the umbilicus.
- C. Measure abdominal girth at the most distended level.
- D. Ask the client if they are distended.
Correct Answer: C
Rationale: Measuring girth at the most distended level and charting it confirms abdominal distention objectively, critical for tracking. Verification, umbilicus measurement, or client query are less precise. Nurses rely on this for accurate monitoring.
When an LVN/LPN is working for a health-care organization that has professional liability insurance, the nurse needs to base a decision on whether to buy individual professional liability insurance on which of the following things?
- A. the possibility that the organization could countersue the nurse in a lawsuit
- B. the cost of professional liability insurance to the nurse
- C. the amount and type of coverage the health-care organization carries
- D. the number of hours worked and the type of nursing work
Correct Answer: A
Rationale: Deciding whether to purchase individual professional liability insurance as an LVN/LPN involves weighing personal risk, and the possibility of the organization countersuing the nurse in a lawsuit is a critical factor. Organizational insurance typically covers nurses acting within their scope, but if a lawsuit arises and the organization's interests diverge such as alleging nurse negligence they might countersue to deflect liability. Individual insurance provides independent protection, ensuring legal defense and coverage tailored to the nurse's needs. Cost, organizational coverage, and work hours are relevant but secondary; cost affects feasibility, coverage might leave gaps, and hours or work type influence risk but don't address the specific threat of a countersuit. This choice emphasizes proactive self-protection in a litigious environment, safeguarding the nurse's career and finances.
The nurse assesses a client at 40 weeks gestation and notes regular contractions and cervical dilatation of $6 \mathrm{~cm}$. Which actions by the nurse are important during this stage? Select all that apply.
- A. Administering the epidural injection
- B. Ensuring adequate hydration
- C. Encouraging the client to void
- D. Monitoring the condition of the fetus
Correct Answer: D
Rationale: At 40 weeks gestation with 6 cm cervical dilatation, the client is in active labor. Monitoring the fetus (D) is critical to assess for distress via heart rate patterns, a priority in labor management. Administering an epidural (A) requires an order and isn't universally needed. Ensuring hydration (B) supports labor but isn't the top action. Encouraging voiding (C) prevents bladder distension but is secondary. D is chosen. Rationale: Fetal monitoring detects hypoxia or distress, guiding interventions like position changes or delivery, per ACOG standards, outweighing comfort or supportive measures in immediacy during active labor.
The parents of a healthy 6-year-old ask the nurse for advice about preventing obesity in their child. Which response reflects health promotion?
- A. Limit screen time and encourage outdoor play.'
- B. Weigh your child monthly to monitor for weight gain.'
- C. Give your child a multivitamin daily to prevent obesity.'
- D. Have your child's cholesterol checked annually.'
Correct Answer: A
Rationale: For a healthy 6-year-old, health promotion prevents obesity by fostering active habits limiting screen time and encouraging outdoor play boosts physical activity, burning calories and building muscle, key to avoiding weight gain at this age. Evidence links sedentary screen hours to childhood obesity; play counters it, aligning with nursing's focus on lifestyle over surveillance. Monthly weighing is secondary, tracking not preventing, and may stress the child. Multivitamins don't prevent obesity caloric balance does while annual cholesterol checks detect, not avert, issues. The nurse's reply promotes wellness through fun, practical steps like biking or tag tailored to a child's energy, ensuring long-term health without medicalizing a well kid, a cornerstone of pediatric nursing's preventive approach.
A theory is a set of concepts, definitions, relationships and assumptions that:
- A. Explain a phenomenon
- B. Formulate legislation
- C. Measure nursing functions
- D. Reflect the domain of nursing practice
Correct Answer: A
Rationale: A theory e.g., Henderson's uses concepts (e.g., breathing), definitions (clarifying terms), relationships (how needs interact), and assumptions (e.g., patients seek independence) to explain phenomena like recovery. This informs nursing actions e.g., why positioning aids breathing. Formulating legislation is policy, not theory's role indirectly influenced. Measuring functions suits research, not theory's explanatory purpose. Reflecting the domain describes scope, not function explanation is active. Theories explain health-related events, providing nurses frameworks to understand and address client needs, making this the precise definition.