Nokea
A client with a fractured femur is in skeletal traction. The nurse should assess for which of the following complications?
- A. Fat embolism.
- B. Hypovolemia.
- C. Osteomyelitis.
- D. Pressure ulcers.
Correct Answer: A, D
Rationale: Fat embolism is a risk with long bone fractures, and pressure ulcers can develop due to immobility in traction.
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The nurse is discussing safety and accident prevention with the mother of a 9-month-old. The teaching has been effective when the mother states which of the following?
- A. I make sure that I keep my cleaning supplies locked up.'
- B. Sometimes she plays in the bathroom when I'm cleaning in there.'
- C. Occasionally she gets under the chair and plays with the telephone cord.'
- D. I've found that those child-protective cabinet locks don't work very well.'
Correct Answer: A
Rationale: Keeping cleaning supplies locked up indicates effective teaching on safety, as it prevents the child from accessing hazardous substances.
The nurse evaluates a client's knowledge as deficient when the client makes which of the following statements about the drug dexamethasone (Decadron)?
- A. I cannot stop the Decadron all at one time.'
- B. If I forget a dose, it's no big deal; I'll just take it when I remember it.'
- C. When I get a cold, I need to let my doctor know.'
- D. I need to watch for an allergic reaction when I first start taking Decadron.'
Correct Answer: B
Rationale: Dexamethasone requires consistent dosing, and missing a dose can have significant effects, indicating a need for further instruction.
A 30-week-gestation client admitted in preterm labor is prescribed betamethasone. What should the nurse tell the client is the purpose for this medication?
- A. Promote fetal lung maturity.
- B. Delay delivery for at least 48 hours.
- C. Stop the premature uterine contractions.
- D. Prevent premature closure of the ductus arteriosus.
Correct Answer: A
Rationale: Betamethasone, a corticosteroid, is administered to increase the surfactant level and increase fetal lung maturity, reducing the incidence of respiratory distress syndrome in the newborn infant. Surfactant production does not become stable until after 32 weeks' gestation. If adequate amounts of surfactant are not present in the lungs, respiratory distress and death are possible consequences. Delivery needs to be delayed for at least 48 hours after the administration of betamethasone in order to allow time for the lungs to mature. The remaining options are incorrect.
An older infant who has been injured in an automobile accident is to wear a splint on the injured leg. The mother reports that the infant has become mobile even while wearing the splint. The nurse should advise the mother to do which of the following?
- A. Notify the physician immediately to adjust the treatment plan.
- B. Confine the infant to one room in the apartment.
- C. Keep the infant in the splint at night, removing it during the day.
- D. Remove any unsafe items from the area in which the infant is mobile.
Correct Answer: D
Rationale: Removing unsafe items ensures the infant's safety while mobile in a splint, preventing further injury. The other options are unnecessary or impractical.
A 20-year-old single parent brings her 3-year-old son into the emergency department because he 'fell.' The child has bruises on his face, arms, and legs; his mother says that she did not witness the fall. The nurse suspects child abuse. While examining the child, the mother says, 'Sometimes I guess I'm pretty rough with him. I'm alone, and I just don't know how to manage him.' The nurse should ask the mother if she would find it helpful to have a referral to:
- A. A program for single parents.
- B. A parenting education program.
- C. A women's support group.
- D. A support group for abusive parents.
Correct Answer: B
Rationale: A parenting education program would provide the mother with skills to manage her child's behavior appropriately, addressing potential abuse triggers and improving parenting techniques.