Nokea
A mother brings her 1-month-old son to the clinic for a well-baby visit. The child has a moderately severe hypospadias that was seen by a urologist in the newborn nursery. The mother is upset that the doctors would not circumcise her son before he was discharged. What information should the nurse include when responding to the mother?
- A. The foreskin should not be removed because it will be used in the repair of the hypospadias.
- B. The child's condition did not allow for elective surgery. It will be done at a later date when he is stronger.
- C. Circumcision is a surgical procedure. Because he will have surgery in the near future, it will be done at the same time to avoid two surgeries close together.
- D. The procedure was not done because circumcision is medically unnecessary, not because he has a hypospadias.
Correct Answer: A
Rationale: Hypospadias repair often uses foreskin tissue, so circumcision is avoided to preserve it for surgical correction, addressing the mother's concern.
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During the charge nurse’s morning rounds, a client says, 'I hope you will take better care of me than the nurse I had last night.' What should be the charge nurse’s initial response?
- A. Apologize for the previous nurse’s treatment
- B. Ask the client to describe what happened last night
- C. Explain that the night nurse was probably busy
- D. Reassure the client that things will be better today
Correct Answer: B
Rationale: Asking for details (B) allows the charge nurse to understand the client’s concerns and address specific issues. Apologizing (A) assumes fault, excusing the nurse (C) dismisses the concern, and reassurance (D) lacks follow-through without investigation.
To maintain Bryant's traction, the nurse must make certain that the child's:
- A. Hips are resting on the bed with the legs suspended at a right angle to the bed
- B. Hips are slightly elevated above the bed with the legs suspended at a right angle to the bed
- C. Hips are elevated above the level of the body on a pillow with the legs suspended parallel to the bed
- D. Hips and legs are flat on the bed with the traction positioned at the foot of the bed
Correct Answer: B
Rationale: Bryant's traction requires hips slightly elevated and legs at a right angle to the bed to align the femur properly and reduce pressure on the pelvis.
The nurse is caring for a client with panic disorder who is reporting palpitations and intense feelings of fear. The client is shaking and hyperventilating. Which of the following actions would be a priority for the nurse to take?
- A. Assess the client for auditory and visual hallucinations.
- B. Administer a benzodiazepine to the client.
- C. Explore possible triggers for the episode with the client
- D. Remain in the room with the client.
Correct Answer: D
Rationale: Staying with the client (D) provides safety and reassurance, reducing fear and hyperventilation during a panic attack. Hallucinations (A) are not typical, medication (B) is secondary, and exploring triggers (C) is appropriate after stabilization.
A client arrives at the clinic for a follow-up after an emergency department visit the night before. The client sustained an ulnar fracture, and a fiberglass cast was applied. Which of the following teachings related to cast care should the nurse reinforce? Select all that apply.
- A. Contact the clinic if any hot areas or foul odors develop in the cast
- B. Cover the cast with a plastic bag for bathing, and avoid getting the cast wet
- C. Elevate the affected extremity above heart level for the first 48 hours
- D. Expect some numbness and tingling of the fingers during the first week
- E. Use only soft, padded objects to scratch the skin under the cast
Correct Answer: A,B,C,E
Rationale: Hot areas or odors (A) suggest infection, keeping the cast dry (B) prevents skin breakdown, elevation (C) reduces swelling, and soft objects (E) avoid injury. Numbness and tingling (D) are not normal and may indicate nerve compression, requiring immediate reporting.
A client diagnosed with endometrial cancer is receiving brachytherapy. Which interventions should the nurse anticipate for this client? Select all that apply.
- A. Cluster care to limit each staff member's time in the room
- B. Instruct the client to be up and around in the room but not to leave the room
- C. Remind family members and visitors to limit close contact with the client
- D. Use protective shielding, if available, when providing direct client care
- E. Wear a radiation badge while in the client's room to measure radiation exposure
Correct Answer: A,C,D,E
Rationale: Brachytherapy involves internal radiation, requiring precautions to minimize exposure. Clustering care (A) reduces staff exposure time. Limiting visitor contact (C) protects others from radiation. Protective shielding (D) and radiation badges (E) ensure safety and monitor exposure. Ambulation (B) is restricted to prevent dislodging the radiation source.