Nokea
A family by court order undergoes treatment by a family therapist for child abuse. The nurse, who is the child's case manager knows that treatment has been effective when:
- A. The child is removed from the home and placed in foster care
- B. The child's parents identify the ways in which he is different from the rest of the family
- C. The child's father is arrested for child abuse
- D. The child's parents can identify appropriate behaviors for children in his age group
Correct Answer: D
Rationale: Removing an abused child from the home and placement in a foster home are not the desired outcome of treatment. Children who are perceived as 'different' from the rest of the family are more likely to be abused. Although legal action may be taken against abusive parents, it is not an indicator of an effective treatment program. Identification of age-appropriate behaviors is essential to the role of parents, because misunderstanding children's normal developmental needs often contributes to abuse or neglect.
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Which of the following is not a step in primary assessment of a client presenting to the emergency department after being involved in a motor vehicle accident?
- A. Assessing and maintaining a patent airway
- B. Obtaining vital signs
- C. Using the Glasgow Coma Scale to check responsiveness
- D. Controlling bleeding
Correct Answer: B
Rationale: Primary assessment in trauma follows the ABCDE approach (Airway Breathing Circulation Disability Exposure). Obtaining vital signs is part of the secondary assessment not the primary survey which focuses on immediate life threats like airway bleeding and responsiveness.
A client with a history of chronic renal failure is receiving hemodialysis. Which assessment finding indicates a complication during dialysis?
- A. Mild fatigue
- B. Hypotension
- C. Slight headache
- D. Stable weight
Correct Answer: B
Rationale: Hypotension during dialysis suggests fluid removal too rapid or disequilibrium syndrome, a serious complication. Fatigue (A), headache (C), and stable weight (D) are less concerning.
A client with benign prostatic hypertrophy has been started on Proscar (finasteride). The nurse's discharge teaching should include:
- A. Telling the client's wife not to touch the tablets
- B. Explaining that the medication should be taken with meals
- C. Telling the client that symptoms will improve in 1-2 weeks
- D. Instructing the client to take the medication at bedtime, to prevent nocturia
Correct Answer: A
Rationale: Finasteride tablets should not be handled by pregnant women due to the risk of fetal harm. Symptom improvement takes months, not weeks, and the medication can be taken with or without food or at any time.
The nurse is caring for a client with a history of a pleural effusion who is scheduled for a thoracentesis. The nurse should:
- A. Position the client flat in bed
- B. Administer a sedative before the procedure
- C. Place the client in a sitting position
- D. Restrict fluids after the procedure
Correct Answer: C
Rationale: Sitting upright with arms supported facilitates access to the pleural space during thoracentesis and reduces complications. Sedatives and fluid restrictions are not routine.
The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client?
- A. Hamburger patty, green beans, French fries, and iced tea
- B. Roast beef sandwich, potato chips, baked beans, and cola
- C. Baked chicken, fruit cup, potato salad, coleslaw,yogurt, and iced tea
- D. Fish sandwich, gelatin with fruit, and coffee
Correct Answer: C
Rationale: Baked chicken fruit potato salad coleslaw and yogurt provide a balanced mix of protein calcium vitamins and fiber meeting pregnancy nutritional needs. The other options are higher in fat or lack key nutrients.