Nokea
A mother calls the school nurse saying that her daughter has developed a school phobia. She has been out of school 3 days. The nurse's recommendations should include which intervention?
- A. Immediately return the child to school.
- B. Explain to the child that this is the last day she can stay home.
- C. Determine the cause of phobia before returning the child to school.
- D. Seek professional counseling before forcing the child to return to school.
Correct Answer: C
Rationale: The appropriate intervention in this situation would be to determine the cause of the school phobia before immediately returning the child to school. School phobia, also known as school refusal, can be triggered by various factors such as bullying, academic stress, separation anxiety, or other psychological issues. By identifying the underlying cause of the phobia, the school nurse can better support the child and provide appropriate interventions to address the specific issues that are contributing to the child's reluctance to attend school. This approach helps ensure that the child receives the necessary support and resources needed to successfully reintegrate into the school environment.
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What instruction should the nurse give to then patient taking propan0lol (Inderal) for hypertension?
- A. Have potassium level checked
- B. Do not stop medication abruptly
- C. Report any changes in appetite
- D. Resume usual daily activities
Correct Answer: B
Rationale: The nurse should instruct the patient taking propranolol (Inderal) for hypertension to not stop the medication abruptly. Suddenly stopping propranolol can lead to rebound hypertension and potentially dangerous side effects. It is important for the patient to gradually taper off the medication under the guidance of a healthcare provider to avoid complications. Therefore, advising the patient not to stop the medication abruptly is a crucial instruction to ensure their safety and well-being.
When taking the blood pressure of a client who has AIDS the nurse must;
- A. Wear a mask and gown
- B. Use barrier techniques
- C. Wash the hands thoroughly
Correct Answer: B
Rationale: When taking the blood pressure of a client with AIDS, it is important for the nurse to use barrier techniques to prevent the potential transmission of infection. This includes wearing gloves to protect against exposure to blood or other bodily fluids, using disposable blood pressure cuffs and stethoscopes, and ensuring proper hand hygiene before and after the procedure. Barrier techniques help minimize the risk of cross-contamination and protect both the healthcare provider and the client from potential infections.
The multilumen pulmonary artery catheter allows the nurse to measure hemodynamic pressures at different points in the heart. When the tip enters the small branches of the pulmonary artery, the nurse can assess all of the following except:
- A. Central venous pressure (CVP)
- B. Pulmonary artery capillary pressure (PACP)
- C. Pulmonary artery obstructive pressure (PACP)
- D. Pulmonary artery wedge pressure (PAWP)
Correct Answer: C
Rationale: The multilumen pulmonary artery catheter, when positioned in the small branches of the pulmonary artery, allows the nurse to measure various hemodynamic pressures. Central venous pressure (CVP), Pulmonary artery capillary pressure (PACP), and Pulmonary artery wedge pressure (PAWP) can be measured accurately at this point. However, "Pulmonary artery obstructive pressure" is not a valid or recognized hemodynamic pressure parameter. Instead, the correct term for this measurement that can be assessed using the catheter is the Pulmonary artery occlusion pressure (PAOP) or Pulmonary artery wedge pressure (PAWP), which reflects the left atrial pressure.
The nurse administered neutral protamine Hagedorn (NPH) insulin to a diabetic client at 7am. At what time would the nurse expect the client to be at most risk for a hypoglycemic reaction?
- A. 10:00 AM
- B. 4:00 PM
- C. Noon
- D. 10:00 PM
Correct Answer: D
Rationale: NPH insulin typically peaks in its action around 6-10 hours after administration. Therefore, after administering NPH insulin at 7am, the client would be at most risk for a hypoglycemic reaction around 10pm. This is when the insulin is exerting its strongest effect, potentially leading to lower blood sugar levels. Monitoring for hypoglycemia during this time frame is crucial to ensure prompt intervention if needed.
Which may be given to high-risk children after exposure to chickenpox to prevent varicella?
- A. Acyclovir (Zovirax)
- B. Varicella globulin
- C. Diphenhydramine hydrochloride (Benadryl)
- D. VCZ immune globulin (VariZIG)
Correct Answer: D
Rationale: VCZ immune globulin (VariZIG) is given to high-risk children after exposure to chickenpox to prevent varicella. VariZIG contains antibodies against the varicella-zoster virus, providing passive immunity to the child. This can help reduce the severity of the infection or prevent it altogether in high-risk individuals. Acyclovir (Zovirax) is an antiviral medication used to treat varicella infections but is not typically used for prevention post-exposure. Varicella globulin is not a treatment for varicella. Diphenhydramine hydrochloride (Benadryl) is an antihistamine and is not used for preventing varicella post-exposure.