Nokea
A mother calls the clinic after her 4-year-old choked on a peanut. The mother reports that she performed abdominal thrusts and the child is breathing normally now. The nurse should tell the mother to:
- A. Bring the child to the emergency department to check for airway obstruction.
- B. Test the child's urine for blood from internal bleeding.
- C. Call the physician if the child begins to sweat and feels dizzy.
- D. Observe the child for difficulty breathing because the abdominal thrusts may have caused a pneumothorax.
Correct Answer: C
Rationale: After choking, monitoring for symptoms like sweating or dizziness is crucial, as they may indicate complications like aspiration or trauma requiring medical attention.
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The nurse is caring for a client with a history of deep vein thrombosis (DVT) who is receiving heparin. The nurse should monitor the client for which of the following laboratory values?
- A. Activated partial thromboplastin time (aPTT).
- B. Prothrombin time (PT).
- C. International normalized ratio (INR).
- D. Platelet count.
Correct Answer: A, D
Rationale: Heparin is monitored with aPTT for therapeutic effect and platelet count for heparin-induced thrombocytopenia.
The nurse is discussing safety and accident prevention with the mother of a 9-month-old. The teaching has been effective when the mother states which of the following?
- A. I make sure that I keep my cleaning supplies locked up.'
- B. Sometimes she plays in the bathroom when I'm cleaning in there.'
- C. Occasionally she gets under the chair and plays with the telephone cord.'
- D. I've found that those child-protective cabinet locks don't work very well.'
Correct Answer: A
Rationale: Keeping cleaning supplies locked up indicates effective teaching on safety, as it prevents the child from accessing hazardous substances.
A client was admitted to the surgical unit after right total knee arthroscopy performed 2 hours earlier. Which surgeon's prescription requires clarification?
- A. Maintain right knee in a slightly flexed position.
- B. Implement patient-controlled analgesia (PCA) per my protocol.
- C. Place sequential compression devices on both legs while on bed rest.
- D. Notify physical therapy to begin isometric quadriceps exercises on the day following surgery.
Correct Answer: A
Rationale: The knee is immobilized by a compression dressing to keep the knee in extension immediately after the operation. The nurse should clarify a prescription to keep the knee slightly flexed. Pain control by use of patient-controlled analgesia, use of compression devices to reduce the risk of thromboembolism, and physical therapy to begin isometric quadriceps exercises are expected prescriptions after total knee arthroscopy surgery.
Which of the following should first alert the nurse that a child is hemorrhaging after a tonsillectomy?
- A. Mouth breathing.
- B. Frequent swallowing.
- C. Requests for a drink.
- D. Increased pulse rate.
Correct Answer: B
Rationale: Frequent swallowing is the earliest sign of post-tonsillectomy hemorrhage, as the child swallows blood from the surgical site. Increased pulse rate may occur later.
The nurse is caring for a client post-thyroidectomy. Which finding indicates a potential complication?
- A. Hoarseness
- B. Incisional pain
- C. Mild swelling at the site
- D. Thirst
Correct Answer: A
Rationale: Hoarseness post-thyroidectomy may indicate recurrent laryngeal nerve damage, a serious complication requiring immediate reporting.