Nokea
A client with acute pancreatitis is experiencing severe abdominal pain. Which of the following orders should be questioned by the nurse?
- A. Meperidine 100 mg IM q 4 hours PRN pain
- B. Mylanta 30 ccs q 4 hours via NG
- C. Cimetadine 300 mg PO q.i.d.
- D. Morphine 8 mg IM q 4 hours PRN pain
Correct Answer: D
Rationale: Morphine can cause sphincter of Oddi spasm, worsening pancreatitis pain, so it should be questioned; meperidine is preferred.
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The home health nurse is visiting a client who plans to deliver her baby at home. Which statement by the client indicates an understanding regarding screening for phenylketonuria (PKU)?
- A. I will need to take the baby to the clinic within 24 hours of delivery to have blood drawn.
- B. I will need to schedule a home visit for PKU screening when the baby is 3 days old.
- C. I will remind the midwife to save a specimen of cord blood for the PKU test.
- D. I will have the PKU test done when I take her for her first immunizations.
Correct Answer: B
Rationale: PKU screening is typically performed at 2-3 days of age to ensure accurate results, as earlier testing may yield false negatives.
A home health nurse visits a 7-year-old boy on neutropenic precautions. His mother cares for him during the day. Which of the following statements by the mother indicates a need for further teaching?
- A. I will call the doctor if my son has a temperature above 38°C.'
- B. My son should protect his skin by showering every other day instead of daily.'
- C. His aunt cannot visit until 3 weeks have passed since her flu shot.'
- D. I will need to throw out the flowers he got as a get-well gift.'
Correct Answer: C
Rationale: Live vaccines (e.g., nasal flu vaccine) require a 3-week wait, but the standard flu shot is inactivated, posing no risk. The other statements are correct for neutropenic precautions.
Which of the following statements reflects Kohlberg's theory of the moral development of the preschool-age child?
- A. Obeying adults is seen as correct behavior.
- B. Showing respect for parents is seen as important.
- C. Pleasing others is viewed as good behavior.
- D. Behavior is determined by consequences.
Correct Answer: D
Rationale: Kohlberg's preconventional stage for preschoolers involves moral decisions based on consequences, such as avoiding punishment or gaining rewards.
The nurse is reviewing medications with a client who is to be scheduled for outpatient rotator cuff repair. Which of the following medications does the nurse anticipate the client will be advised to avoid on the morning of the surgery?
- A. Metoprolol.
- B. Synthroid.
- C. Aspirin.
- D. Prozac.
Correct Answer: C
Rationale: Aspirin (C) is typically avoided before surgery due to its antiplatelet effects, which increase bleeding risk. Metoprolol (A), Synthroid (B), and Prozac (D) are generally continued unless otherwise directed.
The nurse is assessing a client with suspected meningitis. Which of the following findings would the nurse expect?
- A. Positive Kernig’s sign.
- B. Hypothermia.
- C. Soft, non-tender neck.
- D. Decreased level of consciousness.
Correct Answer: A
Rationale: positive Kernig’s sign (pain and resistance on leg extension) is a classic finding in meningitis