Nokea
A nurse is reviewing laboratory findings for three clients. Which of the following laboratory results should the nurse expect for a client who has pancreatitis?
- A. Elevated ammonia
- B. Elevated lipase
- C. Prolonged PT/INR
- D. Decreased albumin
Correct Answer: B
Rationale: Elevated lipase is a specific marker of pancreatitis.
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A nurse is collecting data from a client who is 1 day postoperative following a transurethral resection of the prostate. Which of the following findings should the nurse report to the provider?
- A. Dark red urine
- B. Urine output of 300 mL over 8 hr
- C. Occasional small clots in the urine
- D. Frequent urge to urinate
Correct Answer: A
Rationale: Dark red urine suggests significant bleeding, requiring immediate reporting.
The child has asthma.
A nurse is reinforcing teaching with a parent of a child who has asthma about the administration of montelukast. Which of the following statements by the parent indicates an understanding of the teaching?
- A. I will give this medication to my child every 2 hours if he is wheezing.
- B. I will give this medication to my child once daily in the evening.
- C. I can stop giving my child this medication if he is taking a steroid.
- D. It takes 2 months of scheduled use before this medication is effective.
Correct Answer: B
Rationale: Montelukast is taken once daily in the evening for asthma prevention.
A nurse is assisting with teaching a class about the importance of fire safety. Which of the following hazards should the nurse include as an example of the leading cause of residential fires?
- A. Placing a space heater 5 ft from bed
- B. Smoking in bed
- C. Leaving the stove on
- D. Lack of smoke detectors
Correct Answer: B
Rationale: Smoking in bed is a leading cause of residential fires.
A nurse is reinforcing teaching about newborn care with a new guardian. Which of the following statements by the guardian indicates an understanding of the teaching?
- A. I will bathe my baby under a faucet of running water.
- B. I will wash my baby's face with a warm, wet washcloth without soap.
- C. I will wash my baby's head using a moist towelette.
- D. I will give my baby a bath every day.
Correct Answer: B
Rationale: Washing the face with a warm, wet washcloth without soap prevents irritation, showing understanding.
The client delivered a newborn by cesarean birth 1 day ago.
A nurse is caring for a client who delivered a newborn by cesarean birth 1 day ago. The client requests nonpharmacological interventions to manage pain when changing positions. Which of the following responses should the nurse make?
- A. You can apply counterpressure to your back with each position change.
- B. You should change positions as little as possible.
- C. You can splint the incision with a pillow when changing positions.
- D. You should use patterned-paced breathing when changing positions.
Correct Answer: C
Rationale: Splinting the incision with a pillow reduces pain during movement.