Nokea
A family has taken home their newborn and later received a call from the pediatrician that the PKU levels for their newborn daughter are abnormally high. Additional testing confirmed the diagnosis of phenylketonuria. The parents refuse to believe the results as no one else in their family has the disease. The nurse explains that the disease:
- A. Is carried on recessive genes contributed by each parent.
- B. Is caused by a recessive gene contributed by either parent.
- C. Is cured by eliminating dietary protein for this child.
- D. Will not impact future childbearing for the family.
Correct Answer: A
Rationale: Phenylketonuria is an autosomal recessive disorder, requiring both parents to contribute a defective gene. It is not caused by a single parent's gene, cannot be cured by diet alone (though managed by low-phenylalanine diet), and may impact future childbearing as parents are carriers.
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A client is being treated for acute low back pain. Which of these clinical manifestations must be reported to the physician immediately?
- A. Diffuse, aching sensation in the L4 to L5 area
- B. New onset of footdrop
- C. Pain in the lower back when the leg is lifted
- D. Pain in the lower back that radiates to the hip
Correct Answer: B
Rationale: New onset footdrop indicates possible nerve compression or damage, requiring immediate reporting to prevent permanent impairment. Other symptoms are common in low back pain and less urgent.
To improve the accuracy of client identification, the nurse must use at least two identifiers when providing care, treatment, or services. Which of the following are appropriate? Select all that apply.
- A. Room number.
- B. Bed number.
- C. Medical record number.
- D. Name band.
- E. Social security number.
Correct Answer: C,D,E
Rationale: Appropriate identifiers include medical record number, name band, and social security number, as they are unique to the client. Room and bed numbers are not reliable identifiers.
A primary concern of the hospitalized adolescent is:
- A. Respect for the need for privacy.
- B. Allowing parents to visit after hours.
- C. Wearing a hospital gown.
- D. The fear of loss of control when in pain.
Correct Answer: A
Rationale: Adolescents value autonomy and privacy, which is a primary concern during hospitalization, as it supports their developmental need for independence.
A parent of a 9-year-old child newly diagnosed with diabetes mellitus is very concerned about the child going to school and participating in social events. The nurse creating a plan of care should formulate which goals to address these concerns? Select all that apply.
- A. The child's normal growth and development will be maintained.
- B. The child will use effective coping mechanisms to manage anxiety.
- C. The child and family will discuss all aspects of the illness and its treatments.
- D. The child and family will integrate diabetes care into patterns of daily living.
- E. The child and family will discuss their concerns with the child's teachers and the school nurse.
Correct Answer: D,E
Rationale: To effectively manage social events in the child's life, the family and the child need to integrate the care and management of diabetes into their daily living. In addition, the child's teachers and the school nurse should be aware of their concerns. The other options may be appropriate goals, but they do not deal with social issues.
The nurse manager is developing a 'read-back' procedure to reduce medication administration errors. Which of the following are purposes of the 'read-back' requirement? Select all that apply.
- A. To prohibit orders and test results from being communicated verbally or by telephone.
- B. To ensure that orders and test results that are communicated verbally or by telephone are clear to the receiver of the information.
- C. To make sure that orders and test results that are communicated verbally or by telephone are confirmed by the individual giving the information.
- D. To minimize the risk of non-authorized personnel from giving orders which are communicated verbally or by telephone.
- E. To encourage the use of electronic medical records.
Correct Answer: B,C,D
Rationale: Read-back ensures clarity, confirmation, and authorized communication of verbal orders, reducing errors. It does not prohibit verbal orders or mandate electronic records.