Nokea
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.
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The nurse is teaching the mother of a newborn to care for the umbilical cord. What should the nurse advise the mother to do if the cord becomes soiled with urine or feces?
- A. Swab with alcohol.
- B. Wipe with a dry cloth.
- C. Wash with mild soap and water, rinse and dry.
- D. Swab with povidone-iodine.
Correct Answer: C
Rationale: Washing with mild soap and water, rinsing, and drying (C) cleans the umbilical cord safely without irritation. Alcohol (A) and povidone-iodine (D) may be too harsh, and a dry cloth (B) is ineffective.
The nurse should visit which of the following clients first?
- A. The client with diabetes with a blood glucose of 95 mg/dL
- B. The client with hypertension being maintained on Lisinopril
- C. The client with chest pain and a history of angina
- D. The client with Raynaud's disease
Correct Answer: C
Rationale: Chest pain in a client with a history of angina suggests possible cardiac ischemia, requiring immediate assessment.
The nurse is reviewing medication orders for his clients. Which order would necessitate contacting the health care provider?
- A. Paxil (paroxetine) 20 mg PO daily for a 57-year-old client with social anxiety disorder
- B. Phenergan (promethazine hydrochloride) 12.5 mg PR q12h prn for a child with Reye's syndrome
- C. Diflucan (fluconazole) 150 mg x 1 dose PO for a 24-year-old client with vaginal candidiasis
- D. Lopressor (metoprolol tartrate) 50 mg PO daily for a 48-year-old client with hypertension
Correct Answer: B
Rationale: Promethazine is contraindicated in children with Reye’s syndrome due to the risk of worsening neurological symptoms. Other orders are appropriate.
A 19-year-old female comes into the women's clinic for an STD test. The nurse explains all of the following confirmed cases of STDs must be reported to the Centers for Disease Control (CDC) EXCEPT
- A. genital herpes.
- B. chlamydia.
- C. hepatitis B.
- D. gonorrhea.
Correct Answer: A
Rationale: Chlamydia, gonorrhea, and hepatitis B are reportable to the CDC. Genital herpes is not nationally reportable, though local regulations may vary.
The physician prescribes regular insulin, 5 units subcutaneous. Regular insulin begins to exert an effect:
- A. In 5-10 minutes
- B. In 10-20 minutes
- C. In 30-60 minutes
- D. In 60-120 minutes
Correct Answer: C
Rationale: Regular insulin has an onset of 30-60 minutes when given subcutaneously.